Allowing insurance companies to sell health plans across state lines is “perplexing” to Paul Markovich, CEO of Blue Shield of California, the state’s largest insurer.

Markovich was critical of this proposal from President-elect Donald Trump in an interview with California Healthline, casting doubts on Trump’s claims it would increase competition among insurers and drive down premiums.

“It will push health plans to find the regulatory body or state with the fewest number of regulations,” Markovich said. “It’s a race to the lowest common denominator and least rich benefits. That is what we want to avoid, and I don’t think it will do much to increase competition. I find it perplexing.”

The Affordable Care Act already gives states the ability to allow this practice by joining into “healthcare choice compacts,” but only three—Georgia, Kentucky and Maine—have passed it into law, with none entering into agreements with other states. Insurers haven’t been pushing for the compacts because of the struggles creating an adequate network in an unfamiliar state.

For more on why Markovich and other major California insurers feel Trump may have to change his mind about certain healthcare reforms, click on the link below: