Making Health Care Work

HOLDING HEALTH INSURERS ACCOUNTABLE—CALPIRG is working to make sure health insurers are providing affordable, high-quality care, and not trying to increase profits at our expense.

LOWER COSTS, BETTER CARE

After years of fighting for the right policies and fighting attacks on health care reform, the state's new health insurance marketplace has opened its doors. Covered California is now offering millions of Californians new choices for health insurance.

From the beginning, CALPIRG has worked to make sure the marketplace would use the buying power of millions of Californians to aggressively push insurers for better deals, more competition and changes in how we pay for health care. The plans announced in California are expected to reduce the cost of health insurance for most individuals, while often offering better benefits.

Thanks to new CALPIRG-supported consumer protections, Californians will not be denied coverage due to pre-existing medical conditions. Prices will not vary by gender. Insurers won't be able to set lifetime maximum dollars amounts for health care, and limits on maximum out-of-pocket costs will protect Californians from medical bankruptcy. All policies sold on the marketplace must cover preventive care, prescription drugs, contraception, medical screenings (e.g., mammograms) and other essential benefits, such as pediatric, mental health, maternity and rehabilitation services.

CALPIRG is continuing to work to provide consumers with access to high-quality, affordable care.

  1. Throughout 2013 and 2014, we plan to educate half a million Californians about our new health insurance options and consumer protections, now in place thanks to the Affordable Care Act. Check out our new health insurance guide for young people.
  2. In fall 2012, we launched our Health Insurance Rate Watch project to investigate rate hikes, and to push back against the industry when those proposed hikes are unjustified. See here for a recent victory for California consumers.
  3. We are fighting the high cost of prescription drugs.
  4. We are calling on the legislature to hold health insurance companies accountable for making sure they are reining in excessive prices and unnecessary paperwork, and to give state officials the power to prohibit insurers from increasing rates if they aren't.

Learn more about our priority campaign to end the pharmaceutical industry's scheme to delay cheaper drugs from entering the market:

Issue updates

News Release | CALPIRG Education Fund | Health Care

CALPIRG Education Fund Helps California Students Navigate New Health Insurance Landscape

With the main parts of the Affordable Care Act now going into effect, CALPIRG Education Fund has launched a statewide education campaign reaching out to students with facts about the changes, and tips to help them find the right coverage for themselves.

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Result | Health Care

New Health Care Marketplace Opens

We helped win real reforms that led to the creation of a new California health care marketplace, Covered California. New health insurance options are now available to small businesses and individuals that could save consumers a lot of money. Consumers are able to make choices based not only on cost, and access to care, but the quality of that care.

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Media Hit | Health Care

Pay for Delay

Dr. Michael Wilkes from the University of California, Davis school of Medicine talks about pay-for-delay on his KCRW show "Second Opinion" 

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Media Hit | Health Care

Consumers are paying more money for certain drugs

The California Public Interest Research Group  released the report on  a practice critics call "Pay for delay."   That's when brand name drug companies pay off generic manufacturers to delay putting generic versions on the market.  As a result, consumers end up paying a lot more. The study found in some cases hundreds of dollars more were spent on meds used to treat cancer,  depression and heart disease. 

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Media Hit | Health Care

Pharmaceutical companies pay to delay generics

The report, from the California Public Interest Research Group and Community Catalyst, a nonprofit advocate for affordable health care, said pay-for-delay deals enable companies to continue to sell their brand-name drugs at high prices well after their original patents have expired.

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News Release | CALPIRG | Health Care

Twenty Top Generic Drugs Delayed By Industry Payoffs

The report, “Top Twenty Pay-for-Delay Drugs: How Drug Industry Payoffs Delay Generics, Inflate Prices and Hurt Consumers” reveals that these drugs were subject to an industry practice called “pay for delay,” in which brand name pharmaceutical companies pay off generic drug manufacturers to keep lower cost equivalents off the market, forcing consumers to pay higher brand-name drug prices.

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Media Hit | Health Care

High court rules 'pay-for-delay' drug deals can face antitrust suits

"While we're disappointed the court did not take the next step and outlaw this anti-competitive practice, we expect Congressto now give this issue the attention it deserves and end these deals once and for all," said Austin Price, field director for the California Public Interest Research Group.

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News Release | CALPIRG Education Fund | Health Care

Covered California Announces New Plans and Rates for 2014

“Today’s announcement is the exciting next step in ensuring that Californians can access affordable and reliable heath care coverage,” said Jon Fox.

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News Release | CALPIRG Education Fund | Health Care

Anthem hikes rates 22%

Anthem Blue Cross is moving forward with a new rate hike on California consumers which will leave hundreds of thousands of individuals paying an average 22 percent more for insurance this year. Anthem had proposed raising rates 26 percent, but trimmed the rate to 22 percent after the California Department of Insurance (CDI) found the original increase unreasonable.

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Media Hit | Health Care

Letter to the Editor: Why healthcare costs so much

Wesley Samms' letter to the editor regarding the recent LA Times article: "Small surgery, huge markup," Business, Jan. 31

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Report | CALPIRG Education Fund | Health Care

Making the Grade

Health care exchanges, authorized by 2010’s health reform law, offer the states the chance to address the twin problems of cost and quality, and help consumers get a fair shake when buying insurance. 

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Report | CALPIRG Education Fund | Health Care

Building a Better Health Care Marketplace

The creation of a new health insurance exchange offers our state the chance to build a better marketplace for health care.  The exchange can help individuals and small businesses by increasing competition and improving choices in the state’s insurance market.  By providing better options and better information, and negotiating on behalf of its enrollees, the exchange can level the playing field for consumers.

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Report | CALPIRG Education Fund | Health Care

Building a Better Health Care Marketplace Brief #7

The exchange is a store where consumers can buy health insurance products – and anyone who’s worked retail knows that however much work has gone into crafting strong policies and building an efficient back-office, if customers  can’t understand, compare and choose the products that are right for them, it just won’t work.  

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Report | CALPIRG Education Fund | Health Care

Building a Better Health Care Marketplace: Policy Briefing #6

Medicaid will see its eligibility significantly increased in 2014, the same year the state exchange will open its doors. 

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Report | CALPIRG Education Fund | Health Care

The Cost of Repeal

On March 23, 2010, after a long congressional debate, President Barack Obama signed into law comprehensive federal health care reform legislation, known as the Affordable Care Act or ACA. But the enactment of the law did not end the debate. Even the law’s strongest proponents acknowledge the need for improvements. And across the country, state legislators and Governors have been urged to slow or stop work on implementation of key provisions. The courts are considering legal challenges to the law.

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We’ve got a chance to clean up the health care industry in California, but with lobbyists lining the halls of the state capitol, we need your support.

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