“What kind of a network will an insurance company in Nevada be able to develop for people living in Alabama?”
We need a national marketplace because Americans are a mobile people. Businessmen transact business across state borders and need to be able to have health insurance that provides access in many states. Likewise vacationers need access to doctors and hospitals when vacationing out of state.
I believe that all insurance companies do. And since I have Cigna through my company then there is most likely a network provider in any state I happen to be in. But smaller companies may not have that, and they would charge their policy holders out-of-network costs for treatment.