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The Patient Protection and Affordable Care Act (PACA) includes provisions that allow the purchasing of health insurance across state lines. However, these provisions are structured somewhat differently than earlier proposals. The differences are intended to provide states with more consumer protections from having those regulations undermined by cross state sales of insurance. The most important differences between the PPACA compact provisions and earlier interstate sales provisions are that the PPACA requires all states to comply with a minimum level of insurance regulation, and cross state sales would not be permitted in a state unless that state affirmatively joined a compact with one or more other states.