"Insurance regulators unanimously approved controversial rules Thursday governing how much insurers must spend on patients' medical care -- without adopting any of several last-minute amendments some consumer advocates had feared would gut key provisions. The recommendations will now go to Health and Human Services Secretary Kathleen Sebelius, who has final say." The vote, by leaders of the National Association of Insurance Commissioners, took place after "months of meetings and debate involving industry and consumer representatives. The rules center on the 'medical loss ratio,' which is how much insurers spend on medical care versus administration and profit" (Appleby, 10/20).

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