The federal government’s health insurance mandate is expected to increase the number of insured Americans by one-third. And by increasing the pool to include young, healthy individuals, the premium cost should fall because insurers are able to spread their risk, Allocco said.

That could be good news for many businesses that say health insurance is their second-biggest cost, after salaries.

Just how many people would move into the public plan is a subject of much debate. Lawmakers are proposing that all insurance plans, including the government-run insurance, be available in an exchange where businesses could shop for insurance.

If the exchange is open to all firms, the public plan would enroll about 103 million people, according to estimates from the Lewin Group, a health care research firm that is owned by UnitedHealthcare. If only small firms are eligible for the exchange, public plan enrollment would reach 34 million.

The Congressional Budget Office, however, estimates that just 11 million people will enroll in the public plan by 2019. In any case, the federal government may wind up deciding what benefits private health insurers need to offer.

That could mean more competition among insurers, Allocco said. Right now, each state has its own insurance regulations, making it difficult for firms to easily offer the same health plan in Maryland as they do in Arizona.

BALTIMORE BUSINESS JOURNAL