I think my idea in Post #11 is better. Get the HHS the hell out of health insurance, period.
The only function of "public health care" on a national level is to protect the public from infectious diseases that can spread across large swaths of the population. That's it.
The last thing we need is an arrangement where the U.S. Secretary of Health will invariably become a paid whore of the insurance industry.
Well, that is an option with the understanding that it puts the burden on the states exclusively. 50 insurance markets with 50 different regulation systems. Grossly inefficient however, a model that needs to be retained as some insurance companies only want to compete within a limited geographic area.
Under my recommendation, insurance firms could opt to comply with the national classification system and sell to the entire nation OR they could continue, as you pointed out, to selectively choose to compete under 50 different state regulations.
I am of the opinion that by having a national market, insurance companies can compete nationally and there by, become more efficient, as competition will improve the options to the consumer and prices will be contained.