One biggie is the whole network idea. A person who lives in Florida, for example, and wants to buy a plan sold in North Dakota, is going to have a problem when it comes to finding doctors and hospitals in the network in his state. After all, the network was constructed for North Dakota residents and therefore Florida doctors and hospitals will be in short supply.

Then there’s the idea that people could save money by buying a plan from another state with lesser requirements for expensive benefits — meaning the insurance company is less likely to offer autism coverage, say, or fertility treatments, or acupuncture.

After all, someone without an autistic family member or those who have no interest in fertility treatments and hate the thought of acupuncture needles could probably save a few bucks there.

But again, that doesn’t work as well as one might expect, and one reason is the ACA, which imposed a more uniform standard of offerings required of insurers. So there’s less variation from state to state than one might otherwise expect. While Republicans might be assuming that the ACA will be repealed, thus rendering those standards moot, if repeal doesn’t happen, those uniform standards will stay in place.

And if the kind of coverage in questions is something that a lot of people actually might need — diabetes, say, or cancer — and only healthy people buy the policies from states that don’t require such coverage to be offered so that they can save money, that means that all the people who actually need treatment for diabetes or cancer will have to buy in their home states, thus driving up the price of coverage for everyone in that state.

Last but not least, there’s the fact that if you have a problem with that South Dakota policy, good luck getting any help from your Florida insurance commissioner; he won’t be able to help you with a policy sold in another state.