The point is the managed care market is not structurally similar to a utility company. It is only tax rules that disincentivize people from shopping for managed care.

Whereas multiple utilities are disincentivized due to the cost of moving earth and labor to get you the utility.

Also, I like how the trope is managed care organizations wield unlimited power and make enormous sums of money and have laws that help them benefit over everyone else, but their profit margins and stock returns are abysmal.