Buying Medical Insurance Across State Lines Apr 2026

Most health insurance is still governed by the McCarran-Ferguson Act of 1945 , which gives individual states primary authority over their own insurance markets. Why It Hasn't Happened The primary barriers are economic rather than legal:

Six states—including Georgia, Maine, and Wyoming —have passed laws to allow these compacts. However, as of early 2026, no states have actually joined together in a compact, and no insurers have yet offered a plan across state lines under these provisions. buying medical insurance across state lines

Under the Affordable Care Act (ACA) , specifically Section 1333, states are permitted to form "Health Care Choice Compacts". These agreements would allow insurers to sell a policy in multiple states while following the regulations of just one primary state. Most health insurance is still governed by the