Perhaps I wasn't clear enough that I was talking about the insurance industry in general, not the health insurance industry. Yes, compliance costs in the insurance industry are high. I've worked in the (non-medical) insurance industry for several years, and have personally implemented changes brought about by changing regulations. But I also don't believe they would be anywhere near as high for net neutrality, as long as ISPs were actually being net-neutral. It's a massively simpler proposition to provide non-biased internet service to all customers than to comply with all the state regulations on maritime insurance, keep up with changing state-level regulations, and so forth.
If the topic were regulation of anything IT related at all, perhaps the complexity would be similar to the insurance industry, and then it could start causing problems. But, unless the subject was changed somewhere on page 2, which I skipped, I maintain that net neutrality, even if the laws varied per state, would still be much simpler than insurance regulations.
I also believe that a far bigger threat to U.S. internet technology dominance than ISPs having to spend millions on abiding by net neutrality regulations would be not having net neutrality. Consider something like Netflix, that is high-bandwidth. When it came out, not everyone had broadband, but if you did, you could subscribe to Netflix. What if at the time Netflix first launched their streaming business, ISPs were whitelisting only their own streaming services, and Netflix was limited to 2 Mbps? Netflix would not have been a compelling option in the U.S. at all, besides their DVD operation, and would never have taken off like it did. Meanwhile, foreign video streaming sites would have developed, and eventually one of them (like Spotify in music) would have decided to enter the U.S. market, and (unlike a fledgling Netflix) would have had the money to pay kickbacks to the ISPs to get fast lanes. This is the danger that a lack of net neutrality poses to U.S. internet technology leadership - in a non-neutral environment, new high-bandwidth technologies will be at an inherent disadvantage in the U.S., while foreign competitors in net-neutral countries will be able to develop far more effectively.
I'm also familiar with the auto industry, as I currently work in it. The California/U.S. divide for regulations is one that affects all auto companies selling vehicles in the U.S., so I'm not sure what your point is there. And the lack of U.S. leadership has far more deep-seated issues than regulations, such as lack of quality, that in many cases didn't really begin to be addressed until 2009 and the TARP program.