Selling Health Insurance Across State Lines: An Assessment of State Laws and Implications for Improving Choice and Affordability of Coverage

Proposals to authorize the sale of private health insurance “across state lines” are often promoted to address the challenges of high health insurance costs and a lack of choice among insurers and have been a core component of alternative health reform proposals since the mid-2000s. Critics, however, argue that across state lines proposals would lead to deregulation and a “race to the bottom” where health insurers relocate to the states with the least burdensome regulations.

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