The prevalence of diabetes in America could triple within four decades, government researchers warned Friday.

While roughly 10 percent of adults suffer from diabetes today, that figure is projected to jump to between 20 and 33 percent by 2050, the Centers for Disease Control and Prevention reported. 

The increase reflects (1) an aging population that's more susceptible to Type 2 diabetes, (2) increases in minority populations that are affected by the disease in disproportionate numbers, and (3) the longer lifespans of those living with the condition.

CDC officials said the numbers should be a wake-up call for policymakers hoping to promote wellness and rein in healthcare spending. 

“These are alarming numbers that show how critical it is to change the course of Type 2 diabetes,” Ann Albright, director of CDC’s division of diabetes translation, said in a statement. "Successful programs to improve lifestyle choices on healthy eating and physical activity must be made more widely available, because the stakes are too high and the personal toll too devastating to fail."

Diabetes, the seventh leading cause of death in 2007, is also one of the most expensive conditions to treat, largely because victims also tend to suffer from other serious ailments, like heart disease and kidney failure. 

Recent estimates put the annual cost to treat the disease at $174 billion, with $116 billion going toward direct medical care. 

Old age, obesity and lack of exercise are all risk factors for the disease. Ethnicity also plays a role, with blacks, Hispanics and American Indians suffering disproportionately. 

Of the roughly 24 million Americans with diabetes today, the CDC estimates that 25 percent of them don't know they have it.

The crisis is not just domestic. The International Diabetes Federation projects that as many as 438 million people worldwide will have diabetes by 2030 — up from an estimated 285 million today.

GOP letter follows HHS announcement that 30 companies won't have to meet benefit requirement under new law.

The National Association of Insurance Commissioners (NAIC) voted unanimously Thursday to finalize new rules requiring insurance companies to dedicate more revenues directly to healthcare costs. 

A few technicalities aside, the NAIC kept their "medical-loss ratio" guidelines largely identical to the draft proposal the group approved in September. 

The insurance lobby had fought hard to convince commissioners that the draft would harm consumers' access to coverage, but NAIC members disagreed.

Kansas Insurance Commissioner Sandy Praeger told reporters Thursday that, while there were many amendments on the table, it "wasn't clear" that any one of them would have improved the initial proposal.

HHS likes what it sees

Health and Human Services (HHS) Secretary Kathleen Sebelius was quick to issue a statement saying the rules are "reasonable, achievable for insurers and will help to ensure insurance premiums are, for the most part, supporting health benefits for consumers." 

The recommendations now move to HHS, which still has to certify them. The agency plans to draft their MLR guidelines "in the coming weeks," Sebelius said.

The insurance lobby doesn't like what it sees

Karen Ignagni, head of America’s Health Insurance Plans, issued a one-sentence statement saying the current rules, if allowed to stand, "will reduce competition, disrupt coverage, and threaten patients’ access to health plans’ quality improvement services."

Consumer groups cautiously optimistic

Carmen Balber, Washington director for the advocacy group Consumer Watchdog, said the NAIC deserves a great deal of credit for resisting the pressure from insurers to alter the guidelines. Still, Balber said the final language allows plenty of opportunities for the industry to evade the consumer protections.

“Making these rules work will require tough scrutiny of insurance companies’ spending to make sure they don’t use loopholes in the law to pass off overhead costs as health care,” she said in a statement. 

Brokers weigh in as well

The insurance brokers lobby had pushed NAIC to consider brokers' fees a healthcare expense for the purpose of calculating medical-loss ratios. It didn't happen, but the National Association of Insurance and Financial Advisors (NAIFA) is hoping that could change down the line.

"While disappointed the NAIC did not believe it has the authority to modify the MLR definition to accommodate agent commissions," the group's president, Terry Headley, said in a statement, "NAIFA is hopeful that the NAIC and HHS will side with consumers by recognizing that agents need to be compensated for the vital assistance they provide consumers in managing day-to-day healthcare issues." http://bit.ly/9y7Njw

Liberal group launches effort to combat misleading healthcare reform ads

A coalition of liberal health and labor advocates launched a phone campaign this week designed to combat conservative claims that the healthcare law will steal benefits from seniors — claims Health Care for America Now (HCAN) says are false.

Even with Congress out of session, heated debate over pending food safety legislation continues.

Consumer advocates with the Make Our Food Safe coalition wrote to senators on Tuesday urging them to reject an amendment carving out small farmers. The advocates say they are "deeply concerned about [the] impact on the safety of the food supply" of the amendment sponsored by Sens. Jon Tester (D-Mont.) and Kay Hagan (D-N.C.).

"The exemptions in the Tester amendment are based only on the sales volume of the grower or processor ($500,000 in annual sales) and its geographic proximity (within 400 miles) to a qualified end-user (which can be a consumer, a grocery store or a restaurant)," the coalition said in a statement. "It does not take into consideration the risk to human health posed by a particular food item. As a result, high-risk foods would be exempt from safety regulations."

The National Sustainable Agriculture Coalition, which represents small farmers, responded Wednesday with its own statement.

"On the basis of a surprisingly inaccurate analysis of what the Tester-Hagan amendment proposes to do, the organizations behind the letter to Senators reach a conclusion in opposition to the amendment," said Ferd Hoefner, NSAC’s policy director. "Our strong hope is once they look at the actual details of the amendment they will change their position. The sooner they remove this damaging new roadblock to passage of the Food Safety Modernization Act in the short time left in this session of Congress the better."

Senate Majority Leader Harry Reid (D-Nev.) filed for cloture on the bill before recess. A vote could happen as early as Nov. 17.

The legislation would give the Food and Drug Administration the power to recall tainted food, quarantine geographical areas and access food producers’ records. It was expected to pass by unanimous consent before recess after Democrats and Republicans on the Health Committee worked out a compromise, but Sen. Tom Coburn (R-Okla.) objected.

The House passed its version of food safety legislation in July 2009.

Rep. Jim Marshall (D-Ga.) said this week that Rep. Nancy Pelosi's (D-Calif.) handling of healthcare reform was the last straw influencing his decision to oppose her as speaker if the Democrats keep control of the House. 

"I have been disappointed for some time by the process that we've been following which is not very inclusive," Marshall told Fox News on Thursday. "We're not following regular order. And then [I was] very disappointed by some of the outcomes. 

"The healthcare bill is probably the straw that broke the camel's back," he said. "We had an opportunity there to get costs under control, which is critically important to the nation. [We] didn't take that opportunity, so I think change is in order."

Facing tough reelections this campaign season, a number of Democrats in conservative districts have tried to distance themselves from Pelosi, a California liberal who's been a lightning rod of criticism from the right. But only a handful have said out loud that they'd vote against Pelosi if the party retains its House majority following the elections. 

Last week, Marshall added his name to that short list. 

Not that the Georgia Blue Dog is any stranger to bucking the Democratic leadership. He voted against both the climate-change bill and the health-reform law, and he was just one of two Democrats to oppose the 2009 reauthorization of the State Children's Health Insurance Program.  

The Cook Political Report, an election handicapper, rates Marshall's race a toss-up.

While the National Association of Insurance Commissioners (NAIC) is making headlines Thursday for finalizing its medical-loss ratio rules, the group also — and more quietly — named its new 2011 leaders.

Susan Voss, Iowa Insurance Commissioner, will take over as president, with 
Florida Commissioner Kevin M. McCarty stepping into the president-elect spot. 

Oklahoma Commissioner Kim Holland will be vice president and James J. Donelon, commissioner in Louisiana, will take over as secretary-treasurer.

All but Donelon are currently serving as NAIC officers. Voss is currently president-elect, McCarty is vice president and Holland is secretary-treasurer. 

State insurance officials on Thursday finalized new rules requiring insurance companies to dedicate more revenues directly to healthcare costs.

While Thursday morning's final vote on the medical loss ratio is getting all the attention, state insurance commissioners meeting in Orlando, Fla., have been making progress on other important issues.

On Wednesday, they gave preliminary approval to the disclosure form that health insurance plans will soon have to fill out to let their customers know how they're spending their premiums. The form was approved by a subpanel of the National Association of Insurance Commissioners with only minor technical changes.

The NAIC is not expected to adopt the disclosure forms until later in the year, probably after the Department of Health and Human Services issues regulations on what constitutes "unreasonable" rate increases. Until then, liberal activists will be stepping up the pressure to expand the form to cover more issues.

California-based Consumer Watchdog is pressing for commissioners to include the following as they move forward with the disclosure forms:

• Lobbying expenditures and campaign contributions;

• Advertising and marketing expenditures; and

• Transactions and transfers of funds to affiliates.

"The whole point of the rate justification is to give consumers an explanation of why their premiums are increasing," said Carmen Balber, Consumer Watchdog's director in Washington, D.C. 

Meanwhile, the industry group America's Health Insurance Plans has been arguing against including items not directly related to the rate filing, including lobbying and marketing.

A conservative anti-abortion group has teamed with a liberal civil-rights organization to attack a law against "false statements."