I used to work for BC/BS and they are all organized along agreed boundaries.
This is what Trump was complaining about (having to deal with multiple Blues when going from one state to another).
One of the impacts of this will be the mergers of many Blues (now about 60) into a few large companies.
Up here it has been a monopoly for years. The medical/insurance/government complex has cut the pie to fit them.
Competition would be nice, lots of it.
and no mandates on the insurance.