Um I disagree. The biggest barrier is having the capital to do the thing. I think a number of states have a reduced/free option if your income is below the poverty line (calculated as having low or negative income in the startup phase, not necessarily based on assets), or being lucky enough to have a spouse with healthcare. That said, it's entirely doable to go without healthcare, albeit risky. I started a contracting company 3 years ago with almost no money and the tools I had from my apprentice/jman years, and still don't have health insurance, though I'm hoping to get some later this year.