When I lived in MO, insurance was not mandatory. The law calls for "financial responsibility" which is different. You could post a $50K bond per car and drive without any insurance policy. If you don't get in an accident, you keep your $50K. I don't know about other states.

Thus, at least in MO, it is not extortion. But if you there is no way for you to pay for damage to other peoples' cars and bodies, you shouldn't be driving.

What I don't like is the pitiful level of mandatory coverage required. Bodily injury claims can easily surpass $50K. If you have the minimum level of coverage and hit me, causing injury, chances are good that I will have to tap my own UM/UIM coverage.