In 2015, the US Bureau of Labor Statistics reported that 15 million people were self-employed in the United States. This represented about 10% of total employment. Under the Affordable Care Act (ACA), the self-employed without employees are treated as individuals and are subject to the individual mandates of the policy. Less than half of the American states created health exchanges to act as a marketplace for health insurance under the new policy while the remaining states defaulted to the federal exchange. Using Current Population Survey data from 2013 and 2015, this study finds that the ACA increased the likelihood that the self-employed would privately purchase health insurance. Also, states with health exchanges saw an increase in the likelihood that the self-employed would privately purchase insurance as compared with the states that defaulted. This is important for entrepreneurship since benefits, including insurance, is often cited as a reason for individuals to remain employed as wage earners instead of moving into self-employment. Also, the high costs of health insurance may be a barrier to entry into entrepreneurial ventures and self-employment.