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

Top Twenty Pay-For-Delay Drugs

Californians with cancer, heart disease, epilepsy and other conditions have been forced to pay an average of 10 times more than necessary for at least 20 blockbuster drugs, according to a report released today by California Public Interest Research Group (CALPIRG) and Community Catalyst.

 

 

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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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Blog Post | Public Health, Health Care

Supreme Court hears arguments on ‘Pay for Delay’ Case

Big Pharma’s anti-competitive practice costs consumers $3.5 billion a year. The 1984 Hatch-Waxman Act was originally intended to increase the availability of generic drugs by allowing generic manufacturers to challenge the patents of name-brand drugs. What emerged in the aftermath was a practice where patent-holding pharmaceutical companies simply paid generic manufacturers not to challenge their patents, thus delaying the release of generic drugs for years. 

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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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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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Media Hit | Health Care

The Sacramento Bee: The Conversation: Stuck in no man's land for health coverage

One man's story of the obstacles he encountered trying to purchase health insurance on the individual market illustrates why the changes coming n 2014 are so important.

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News Release | CALPIRG | Health Care

Health Care Reform Benefiting Californians

To mark the second anniversary of the Affordable Care Act we collected stories from our members who are benefiting from health care reform.

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News Release | CALPIRG | Health Care

CALPIRG Supported Law Saved Consumers $127 Million in Health Care Premiums

In 2010, CALPIRG helped pass a law requiring insurance companies to disclose the justification for their health insurance rate hikes. The disclosure uncovered errors and unjustified claims by insurers that saved Californians $127 million on their health insurance rates in 2011. 

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News Release | CALPIRG | Health Care

Supreme Court to Hear Challenges on Health Reform

The Supreme Court’s decision to hear arguments on the new health reform law means that soon, the question of its constitutionality will be settled, allowing states and policymakers to focus on lowering costs for consumers without being distracted by counterproductive lawsuits. Upholding the law would be a clear win for consumers, while a bad ruling would pull the rug out from under states and consumers.

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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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