Okay ... how does that save money if out-of-state insurance companies are locked into the same parameters as in-state insurance companies?
I'm really not trying to be argumentative ... I really do not understand how this works to the individual's financial benefit.
Go for a high deductible, but lower coverage major medical plan--pays on day surgery and hospitalization that will 'fit' with the requirements of several states. Because the plan does not cover prescription drugs, checkups, and the minor visits, it is cheaper all the way around. It only pays out on major problems and kicks in at 3500, 5000, or 10K. The plan I had had a 5K per event deductible and 80/20 copay to 10K, after that the plan picks up everything connected with the hospital stay or surgery. Considering I had the plan 20 years, I'm still pretty healthy, and do not take any meds, it fit just fine. Two surgeries, one for an umbilical hernia, one for the removal of a basal cell carcinoma (with frozen section checks for a clear margin) qualified. One stay for pneumonia, also (two days), this in 20 years. I also paid cash for my granddaughter's braces, as I had seen that coming and started putting the money aside during the run-up to the oil boom (income in the mid to upper 5 figures at the time). My wife is pretty healthy as are the kids (two grandkids we are raising, now teens).
Theoretically, my wife and the kids are covered under Indian Health (one of the reasons I was so against Obamacare, I have seen what the Feds can do to a healthcare program). In reality, we paid cash out of a HSA, so those payments were made with money put in the account which was not subject to Federal Income Tax if used for Medical expenses. During the best years I made the maximum allowable deposit to that fund.
Compared to the current "exchange" plans, with 14K deductible and 28K annual premium, my old plan with a 6K annual premium, even with the average 8K payout for a family of 4 for dental, optical, the odd prescription, and doctor visits, the savings were huge.
The liability with the obamacare plan (the cheap one in this state) is 28K (for premiums) plus 14K deductibles, or 42K. With the catastrophic plan I had, average outlay (premiums and actual expenses) was under 14K, one third of the Obamacare cost. Even if you just included the Obamacare premiums and our actual cost under the Oamacare plan, that would only bring it down to 36K a year, which, last year would have left us under 10K to eat on and keep the lights lit--for the year (oil boom over).
In a land of stable six figure incomes, that Cadillac (Obamacare) plan might somehow make sense, but in the feast or famine world of the oil patch, no way.