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

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.

> Keep Reading
Report | CALPIRG Education Fund | Health Care

Review of Anthem's Rate Increase on Individual Policies

CALPIRG Education Fund has reviewed a massive new rate increase proposal from Anthem Blue Cross. 340,000 Californians can expect to see rates increase an average of 20% this year, with some as high as 24.9%. CALPIRG Ed Fund has recommended that the California Department of Insurance request that Anthem amend the rate change or make an official determination that the proposed rate change is unreasonable.

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Report | CALPIRG Education Fund | Consumer Protection, Health Care

CALPIRG joint letter on Consumer protection for “California Covered”

CALPIRG joins a coalition of consumer advocates in preventing risks to consumers using the new health benefits exchange known as “California Covered.”

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Report | CALPIRG Education Fund | Consumer Protection, Health Care

Comments on the Aetna Life Insurance Company Proposal to Increase Rates

Nearly 70,000 Californians in small group insurance plans will see rate hikes averaging 8%, with some as high as 22%, if the premium rate hike proposed by Aetna Life Insurance Company go forward. After careful analysis of Aetna’s filing, CALPIRG is concerned that Aetna has not provided sufficient information to justify this rate increase.

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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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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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News Release | CALPIRG Education Fund | Health Care

California's Health Exchange on Track to Lower Costs for Consumers

California’s health insurance exchange has the potential to be a national leader in delivering better value for consumers, according to Making the Grade, a new report by CALPIRG Education Fund. 

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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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Report | CALPIRG Education Fund | Health Care

Playing by Their Own Rules

This white paper examines the rules the drug companies have set for themselves, assesses whether they comply with the minimum requirements of SB 1765, and identifies aspects of the drug company rules that are deeply problematic.

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Report | CALPIRG Education Fund | Health Care

'Tis Always the Season for Giving

Desperate to rein in skyrocketing prescription drug costs, lawmakers, healthcare plans and individual consumers are taking a much closer look at the promotional practices of the pharmaceutical industry. One aspect that has come under heavy scrutiny is a marketing technique known as detailing. This white paper examines the mechanics and potential harms of pharmaceutical detailing, describes the steps that have been taken to address those problems, and explores policy options for addressing the issue.

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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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