Regarding increased competition in the health insurance market, I have never been able to get an answer to this question. Do higher population states have more competition? With more potential customers operating under the same regulations, I would think yes. So these states would have may have lower costs because more insurers would be enticed to compete with the hope of greater reward.

It is hard to do apples to apples comparison as regulations are different in each state, but the health care rate of inflation should be lower where there is greater population/number of insurers to keep increases in check. I wonder if that is true. Also, I wonder what the profit margins are at insurers in states with more/less population and more/less competition. Well Point has over 60% of the Missouri market so they should be able to squeeze the health care providers on one end and the policy holders on the other with their market dominance and making a mint here compared to other states. I don’t know if that is actually true, and they probably won’t volunteer the info. Maybe some sharp people at a well-regarded think tank could take it up.

My sneaking suspicion is that one of the barriers to entry, setting up a network of physicians and hospitals that is any good, would provide a pretty big barrier to entry for the OOM insurer. People are particular about the doctor/hospital they go to and if the OOM insurer doesn’t have what you want, the OOM insurer loses out on your business unless the price is steeply discounted.

There is a very reasonable chance that your employer chooses for you and only the boss’s preferences are significantly taken into account.

Too long.