Basically, in principle, if all the states started doing this, it would be no different than the federal level. The only main differences would be different flavors of health insurance companies practices per differing state laws. In the end, pretty much what we are getting anyhow.
What I would like to see is the separation of health care and employers. I thought the integration of those two was stupid to being with and my stance still hasn't changed. It is because of unions they were forced to be together, and as such it created some nasty health insurance company monopolies in a few states. Which is where all the really bad practices came from eventually.
Make everything ala cart in my opinion. Do it like Japan and the French. Make all insurance companies able to offer health insurance like every other insurance. You like Geico? get their home, car, and health insurance for bigger discounts over all. Like Statefarm? same thing. Then mandate health insurance is non profit. Mainly because it is someone required by law. This way the companies compete over what other insurances they offer. They get more money from other insurance services which are more privileges than needs. Consumers make out and everyone is happy.
I'm all for health insurance reform and happy it's going through. I'm not so happy and a little leery about our current reform changes are, but I'm hoping it will get worked out.