“Why can’t we buy insurance across state lines?”
The idea that buying across state lines would save money is a myth for several reasons.
The state insurance commissions dictate what coverage must be provided within a state. Adjacent states will likely have different coverage requirements. Different coverage requirements means different costs.
Second, the costs of providing medical coverage are also a function of the state. An insurance company providing coverage in Alabama will face different costs than one providing coverage in New York. The physicians will cost more, their offices will cost more, etc. Then too, their liability insurance costs will differ.
Third, you could perhaps save some money but you would have to travel to the state where your insurance contract is written to get coverage.
Yes, the state lines boundary is silly. Blue Cross is all over creation, licensed state by state. Other companies could do the same. The problem is the COST of care. There is no magic way to painlessly relieve every single American of ten grand apiece each year, which is what the cost is.