Aside from the fact that insurance is a sucker's bet, it's not voluntary anywhere but New Hampshire. I'm not there yet. So here it is another expense tacked on by the state, for a service frequently in conflict with its customers. Insurance as it exists wouldn't exist without the state.
I think everything that exists to some degree is shaped by its environment. But NH has no required insurance, though contractual obligations might impose some. Most insurance regulations in NH are imposed upon the industry. Such as requirements to cover individuals at a rate that is under market value according to risk assessments.
This of course transfers cost to others, and makes them reassess their risk/reward ratio.
The end result is that those with very low risk, simple don't purchase. While those with very high risk complain about the increasing costs associated with it, and seek legislation to 'force' the market to their will.