One of the largest and seemingly most unnoticed changes recently has been the consolidation of local hospitals into regional monopolies. It was already difficult to compare pricing in healthcare, now imagine when there are no other choices in your area.

It's vaguely true. Insurance policies are regulated at the state level (so to be sold to residents in a state a policy has to follow the regulations in that state). It's kind of hilarious that the conservative, small government party is proposing to federalize this regulation.

The reality is that the policies that companies will be willing to sell across state lines are likely to be truly awfully shitty, by doing things like not having a coverage agreement with most hospitals (which will at least drive up out of pocket costs and complicate claims, if not enabling the companies to outright deny claims).

This is not a thing you can legislate away effectively. The key to understanding here is that negotiation for health care is hard due to the fractured nature of providers and care. Insurers are micro-monopolies because they tend to serve districts or business sectors more effectively (cheaply) than others and rise to the top, but without a huge base of citizens to negotiate for no significant pricing change can really occur.

Providers? Thats doctors and hospitals. Im not aware of anything but natural monopolies. Insurance company competition is rather low in my opinion. They are exempt from antitrust law[0] and can virtually collude to set prices.

[0]https://en.m.wikipedia.org/wiki/McCarran–Ferguson_Act