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

Report | CALPIRG | Health Care

California Health Insurance Rate Review

In its first three years, health insurance rate review in California has saved consumers and small businesses $349 million.

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Report | CALPIRG Education Fund | Health Care

Comments on the Anthem Blue Cross Proposal to Raise Health Insurance Rates

Anthem Blue Cross has proposed rate increases as high as 24.9% for policyholders in their “grandfathered” health insurance plans that were established before the Affordable Care Act was signed into law. The rate changes average out to a 16 percent increase for 153,000 policyholders, impacting a total of 238,000 Californians currently covered under the plans. Our review found that Anthem failed to provide adequate justification for this rate increase.

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Media Hit | Health Care

Anthem to raise some premiums as much as 25%

Los Angeles Times: "We are very concerned Anthem proposed a rate hike this high without adequate justification," said Emily Rusch, CALPIRG's director.

> Keep Reading
News Release | CALPIRG Education Fund | Health Care

Top Tips for Getting Youth Enrolled in Covered California

CALPIRG Education Fund helps young people check out their coverage options through California's separate health insurance exchange.

> Keep Reading
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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Media Hit | Health Care

Drug Makers Stall Generics With “Pay For Delay” Says CALPIRG

The California Public Interest Research Group or CALPIRG has released details on what it says is a practice that leads to prescription drug price inflation. CALPIRG calls it “pay for delay.” CALPIRG says the practice of keeping generics off the market makes consumers pay more for medications that treat conditions like cancer and high cholesterol.

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Media Hit | Health Care

CALPIRG study claims drug companies hold back generic meds

SACRAMENTO, Calif. (KCRA) —A study by a public interest group found Californians have overpaid for medications because brand-made drugs were delayed from reaching pharmacies.

Read more: http://www.kcra.com/news/calpirg-study-claims-drug-companies-hold-back-generic-meds/-/11797728/20945964/-/uh9rdr/-/index.html#ixzz2YrSJnikK

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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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Report | CALPIRG Education Fund | Health Care

At Stake: What’s on the Line for Health Care Consumers in the Pending Supreme Court Case

The outcome of the U.S. Supreme Court’s ruling on the Affordable Care Act (ACA) will have far reaching impacts on consumers. The law is already working to improve the quality of care and reduce costs, with millions of Americans experiencing concrete improvements in their coverage.

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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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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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