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.

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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.

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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

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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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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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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