This is America, we’re supposed to have interstate commerce. If you choose not to do business with out of state firms that’s up to you. But if someone want’s to buy a policy from a company in another state, why shouldn’t they? Generally increased competition is a good thing. You have some states where there are only one or two companies to choose from.
You didn't answer my questions so let me try again. To begin with let's agree that insurance companies can do business across state lines otherwise companies like Cigna or Blue Cross wouldn't be in business. But in order to do so they have to meet the regulatory requirements of the states they are doing business in and yes, those requirements can vary from state to state. But to just pass a law saying that an insurance company not registered in Missouri can now sell me insurance and say that will solve the problem through greater competition ignores the way insurance companies do business.
I have insurance through my Cigna. It's great coverage and I'm happy with it but say I found a South Dakota company not doing business in Missouri and I find that I like the premium they offer better. The argument is I should be free to pursue the lower premium and that competition will lower costs as a whole. But the reality is that I would be an idiot for buying that policy and the South Dakota company has no motivation to sell to me. And it's because of the way insurance companies do business.
If I go to my doctor then as long as they are part of the Cigna network I pay a $15 or $20 copay. I have a fairly low deductible and pay 20% of the costs of medical work until the deductible is met. I have a total out-of-pocket expense of about $2000. Like I said, it's great insurance and as long as I stay with in-network providers then it meets my needs and my expected medical costs for the year are very predictable. From Cigna's standpoint they can predict their expenses with a fair amount of accuracy because they have negotiated set prices for all the services their network provides. So they can set their premiums based on that. It's win/win for both sides.
But now I go to the South Dakota company and all bets are off. To begin with I'm still going to go to my local doctors and not travel to South Dakota. But the South Dakota company has no network of providers in Missouri; why should they since until today they did no business here? My co-pay is no longer $15 for a normal office visit but it's 20% of whatever my doctor charges. My share of medical procedures is no longer 20% it's now 30%. My deductible is no longer $2000 it's $6000. My out of pocket costs have gone way up so my premium had better be pretty low to make up for it. But will it be? The South Dakota company based their premium on their known costs and expected payouts. But without a network in Missouri then they have no negotiated rates for services. Setting up networks are expensive and they certainly will not go through the time and expense for one, or even a handful of customers. So they will have to pay whatever the doctor or hospital cares to charge. Their cost structure is no longer valid and unless they want to lose money then they will have to charge me a much higher rate than their other customers. There goes my savings.
To say that selling insurance across state lines is a solution for health insurance costs is fantasy. It will do nothing. There is no incentive for me to buy and even less incentive for companies to sell.