Despite the potential to make more money, companies haven’t jumped at the opportunity in states that have lowered barriers. Insurance department officials in Georgia, Maine and Wyoming told Governing that no out-of-state insurers have expressed interest, and no such policies have been sold.
Denise Burke, a senior policy and planning analyst with Wyoming’s insurance department, suspects the state’s extremely low population density and the difficulty of building a provider network has discouraged insurers. “Accessibility, getting and keeping qualified providers — insurance companies are simply not interested in pulling us into the fold,” she said.
The investment of building a network of doctors in a state often comes up as a bigger barrier than state regulation, even among some supporters of the idea of selling policies across state lines. Thomas Miller, a resident health care fellow at the conservative American Enterprise Institute, acknowledges “it’s not easy to be a new insurer overnight,” but he says there are a few ways to make the investment more worthwhile.