Red, There is no national law preventing insurance companies crossing state lines. Each state has their own insurance laws. It's one of those states rights things the states still have. If an insurance company wants to enter the market in another state they only need to have each policy comply with that state's laws. That's all. Premera is also in the State of Washington. Moda is in 4 States. You've been misled by talking points from people just angry about Obamacare and how it limits all health insurance companies to no more than a 20% profit each and every year.