Categorize the comment on the basis of insult. If the comment is insulting output Yes, otherwise output No.

I believe my memory on this is accurate. Insurance companies are regulated by the states with varying degrees of scrutiny. Policies being sold across state borders would have opened the door to federal regulation. The insurance companies prefer the state by state approach because it benefits them. They can charge premiums that are very different from state to state without disclosure to the state regulators, only controlled by the existence of competition. 
Alaska is a small market in which many specialists have combined into large group practices, reducing competition for inclusion under medical insurance plans and giving them leverage.  It's the free market system, just like our gasoline situation.
No