Insurance companies vote with their feet. The practical reality is that if insurance companies are able to make money in a given state, they'll stay in that state. Insurance companies fleeing states like CA or FL in droves is a really good indication that the actual, hard reality on the ground is that they can't make money when the regulations are stacked against them. That's fine for insurance companies - they'll just go somewhere else - but it's really bad for the people who need insurance.