Why can I get a good insurance for a reasonable price while some people have to pay over a thousand for terrible insurance?

I'm 29 and in VA and am opting to get individual insurance this year instead of through my employer, and my premium for a BCBS HMO Gold plan is "only" $440/mo. Overall it's a great plan – $1750 deductible, office visits are copays even before the deductible is met with PCP/therapy being $0 while specialists are only $30. I had this plan last year and went to the doctor a ton and never had any issues.

I'm shocked to see that people in other places are having to pay $1k+/mo for high deductible plans. I read online that more populated areas tend to have better premiums because there's more providers and so more competition to keep costs low, and that state regulations can help or hinder insurance costs but I've never really thought of Virginia as a particularly progressive state in terms of social welfare.

Are health insurance costs really just kind of luck of the draw in terms of where you end up living? It's insane to me that someone the next state over in Kentucky would have such drastically worse health care coverage.

submitted by /u/Penniesand
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