[tomohawk]

You cannot purchase plans across state lines. You cannot purchase the same plan you would get if you worked at a large company.

The law is basically written by the insurers, and favors them. It allows them to segregate people based on who they work for, etc.

In an ethical system, there would be just a single, non-segregated pool of people called a 'market', and anyone would be able to purchase any plan they want from that market, regardless of which state they lived in and regardless of who they did or did not work for.

Federal employees have such a system, and prior to obamacare, there was actually bipartisan agreement forming around enabling everyone to participate in that system. It's probably why obamacare was rushed through quickly by the insurance companies.

[amluto]

The state line thing makes a degree of sense in the context of the (extremely broken) network system. Your insurer has a network of providers with whom they have negotiated rates. If you live far away from your plan’s intended market, you won’t be near the network, and everyone loses except the medical providers who get to overcharge you and your insurer as a result.

It should be quite evident that everything about this system is broken, but this is part of how broken systems get entrenched.

[ecommerceguy]

I should remind everyone it is a republic and if you think state insurance commissions will let go of their fiefdoms I have some land in Florida I'll make you a great deal on. Kathleen Sebelius comes to mind!!