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

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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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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News Release | CALPIRG Education Fund | Health Care

Aetna reduces rate following CALPIRG Ed Fund's review

 This week, Aetna Life Insurance Company announced plans to reduce its proposed increase in health insurance premiums. In November, CALPIRG Education Fund completed a review of the rate hike and recommended that the California Department of Insurance declare it unreasonable. Now, 68,000 small business employees impacted by the rate hike will see a significantly smaller increase in their health insurance premiums.

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News Release | CALPIRG Education Fund | Consumer Protection, Health Care

Hospitals in the Bay Area are Most Expensive in the State for Surgeries

A new report by CALPIRG Education Fund found large discrepancies between what California hospitals charge for common surgeries, which appear unrelated to quality of care.

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News Release | CALPIRG | Health Care

Statement by Pedro Morillas CALPIRG Legislative Director on U.S. Supreme Court Decision to Uphold Health Reform Law

Today’s decision is good news for consumers in California. Insurance companies can’t go back to the days of dropping your coverage once you become ill, or denying coverage to sick children. And beginning in 2014, the days of insurers being able to deny anyone coverage for “pre-existing conditions” will be history.

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Media Hit | Health Care

In California, Aetna raises health insurance rates for small businesses

If politicos in Sacramento and Washington are serious about creating quality jobs in America, they should embrace efforts to rein in unsustainable health costs for small-business owners and their employees," said Austin Price of CALPIRG. 

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News Release | CALPIRG | Health Care

Aetna Rate Increases for Small Businesses “Unjustified”

Sacramento, CA – The California Department of Insurance issued a statement today finding new rate increases of up to 21.4% annually for some small business health plans sold by Aetna unreasonable.  Aetna attempted to justify the increases with projections for medical costs in excess of their actual experience and also in excess of federal measurements of medical inflation.

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Report | CALPIRG Education Fund | Health Care

Cutting Red Tape in Health Care

California’s health care system is broken. Costs are rising faster than either inflation or wages, and wasteful spending is a major culprit. Inefficient and duplicative administrative systems force doctors and hospitals to spend more time and money on administrative support than is necessary, which increases costs to patients.

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Report | CALPIRG Education Fund | Health Care

The Facts About Comparative Effectiveness Research

As Congressional and public debate over health care reform grows more intense, comparative effectiveness research (CER) has emerged as an unlikely flashpoint of controversy. Opponents’ claims that CER results in the rationing of health care or a government takeover are belied by the true nature of such research: it is simply fundamental scientific research of medical treatments aimed at determining the most effective ways to treat sickness and injury. It is the basis of all advancements in the field of medical science and has been used throughout history to improve medical treatment.

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Report | CALPIRG Education Fund | Health Care

Putting America Back to Work

As the national health reform debate begins in earnest, some pundits have suggested that America cannot afford to invest in health reform. The resounding response from political and thought leaders has been that America can't afford not to. 

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Report | CALPIRG Education Fund | Health Care

More Bang for the Health Care Buck

The high cost of health care in California imposes an increasing burden on households, businesses, government, and the state’s economy – a burden made heavier by the current economic crisis.  The money that insurance companies spend on inefficient administration, billing and marketing – instead of medical care for their enrollees – contributes to the high health care costs Californians must endure.

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Report | CALPIRG Education Fund | Health Care

Paying for What Works

Our health care system is in crisis. Interrelated problems with the affordability and quality of care are undermining patient care and threatening the economic future of American families and small businesses.  This policy primer is intended to help meet that challenge. It examines seven factors which have led to the interrelated crises in cost and quality, and prescribes specific policy remedies to tame costs and restore health professionals’ ability to provide the care on which American families rely. 

 

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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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