Hey Marie,

Thank you for your question.  I believe that the key phrase here is "Prior to the last decade".  The federal law that has ruled through the years is the McCarran-Ferguson Act (Public Law 15) passed in 1945.  This law exempted insurance from federal antitrust laws to the extent insurance is regulated by the states.  This was a very astute observation on your part.  I believe that I will rework this question for future students.  In the meantime, the answer is still States.  Thank you.

Kindest regards,

Jerry Bateman