Your simplified attempt to make a point here neglects one important factor in your analysis. Sure all they have to do is go to a desired state, once there they have to set up new corporate offices. Each state will require a corporate charter to be paid in that state. It isn't as simply as just move there like you're a fast food chain. Health insurance law is very complex. This will require a tremendous duplication of costs. Also, I do believe, but I am not certain that there is also quite a bit of federal red tape to go through as well. Congress loves their interstate commerce powers. The main idea here is that government (state and/or federal) intervention, by means of excessive and burdensome legislation raises significantly the cost of doing business.