While we all follow things like this closely (because it involves real reform), few others do. There's only a tiny amount of honest criticism of this on the air waves. In addition to all the reflexive low-IQ antagonism toward anything that is other than a federal takeover (i.e., remaining private rather than being “public”), a few have noted that people in State A will have little or no recourse if there are problems with insurers in State B. The Insurance Commissioner and other State A officials cannot do much, if anything, about an insurer or any problems with companies in State B. That's a legitimate concern. Where liberals really have failed here is, once again, their failure to think more, and understand that this raises a more general concern for the many of them who (wrongly) want elaborate minimum benefit packages, the farthest from true insurance (catastrophic care), typically involving all kinds of things that properly are elective, as well as overly-hyped preventive care (all the other things that drive up the costs of insurance for everyone in places with big minumum package laws in states now). Namely, what they're missing is a common kind of concern of theirs, which has specific health-care effects in ways particularly objectionable to them. What you would see with cross-state insurance purchases is the specter of a “race to the bottom,” the phrase used to mean that states will compete with each other to reduce entitlements or other government benefits in order to reduce their relative position relative to other states, to avoid being a “magnet” state. (Example: If Massachusetts required all health “insurance” to be as lavish as possible, including not only preventive care but all kinds of things like cosmetic surgery, massage, etc., and had community rating within Massachusetts, it would be attractive to people in all the other states, and people elsewhere would deluge the Massachusetts system. This would raise the size and cost of the bureaucracy and challenges to that state and costs and complexity with those insurers, and as a consequence, the state might revise downward its benefits. That's totally aside from the other likely decision by some states to restrict or prohibit out-of-state sales or the kinds of policies that could be bought by people in other states.)

I'm in! Heck…. I'd allow interplanetary sale if I thought it would help!

True, true, true. That's what true reform is all about. It has nothing whatsoever to do with the public option, which of course has nothing to do with “reform” or with (rigged, fake, engineered-crowding-out) “competition,” but is an incrementalist strategy for federal takeover of health care (which the public rejects as an open, honest, complete, rapid move, hence the need for incrementalism and indirection in the form of words, if not also deeds).

We all agree that the healthcare system needs fixed.
The liberals wish to scrap the whole thing and install socialized medicine.
The conservatives aren't offering up much of an alternative.
The moderates among us think that you should regulate the industries that are key to the problems.
Namely phamaceuticals, insurance, healthcare, and legal reform.

The main hurdle to this approach is that those four industries above have Congressional member of both parties in their pockets.

Congress needs to do what's good for America for a change, and let their paid lobbyists here an unfamiliar word, “NO!”. All a lot of us ask is to give that a chance. If that approach doesn't work, then go ahead and put the single-payer in.