Not that I'm aware of, but probably due to 9-11. I didn't travel internationally much before 9-11.

On insurance, I'm not exactly sure. I know the interstate commerce clause doesn't affect corporate policies, only individual ones. I believe it has to do with state regulation of in-market providers (health care systems where the patients are), taxes and equalized competition (cost controls), but again I'm not 100% sure. The ACA is federal, so they can regulate at the fed level and maintain control over the states.