Not sure where "fake insurance" came from? I don't disagree with the state compliance, my point is that nationwide groups would have pricing power to negotiate rates. ACA is not negotiated, it's mandated and subsidized with no benefit to the vast majority of consumers. The only beneficiaries of ACA are the poor and those who have major pre-existing conditions. Yes, ACA policies have many parts of the large policies with out the consumer getting any choice in coverage. Obviously you're involved in the industry(probably govt) and don't pay your own premiums if you think the ACA is affordable or working.  I get that you want to continue a political fight rather than fix this so your side can "win." Most of us want the system fixed and people to have a choice AND be covered.