I have lived all over and had health insurance through my husbands employment for the last 32 years, But as a kid I didn’t, we never went to the doctor unless we where really at deaths door. In Hawaii I experienced HMSA. As I understand it(And I could be wrong) when insurance companies first wanted to write in HI. The state government said we are one people you will charge the same for all Hawaiians or not write here. Guess what they chose not to do business in HI. HMSA was developed by the doctors and hospitals to fill the gap. Everyone in Hawaii is covered either by their employer or by the state all at the same per person rate. People in Hawaii are very poor. The difference between the wages that regular working class people earn compared to the cost of living is huge, But all have health care. If it works for Hawaii why not the rest of us?