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 | Health Care

Bill to Set Limits on Rx Gifts to Doctors Has its First Vote

Today the Senate Health Committee will vote on CALPIRG-backed legislation by Senator Mike McGuire, SB 790, to rein in pharmaceutical company gifts to doctors. We believe this bill is an important complement to other efforts to increase transparency and accountability in the industry.  

> Keep Reading
Blog Post | Health Care

Our Statement on the American Health Care Act | Jesse Ellis O'Brien

Instead of taking on the high cost of health care and other urgent problems for consumers, Congress may be on the verge of severely damaging the nation’s health insurance markets, raising costs and degrading care for millions of Americans.

> Keep Reading
Blog Post | Health Care

PIRG applauds decisions blocking health insurance mega-mergers | Jesse Ellis O'Brien

This week, in a big win for consumers, a district court took action to block the proposed merger between health insurance giants Anthem and Cigna. This decision follows a ruling last month that blocked the proposed merger of two more of the nation’s biggest for-profit health insurers, Aetna and Humana. These decisions come after months of work by U.S. PIRG and a broad coalition of consumer and health care groups, urging close scrutiny of the mergers from state and federal regulators and raising questions and concerns about the potential impact of the mergers.

> Keep Reading
News Release | CALPIRG | Health Care

Key Patient Rights Bills to Prevent Unfair Health Care Costs Face Crucial Votes This Week

SACRAMENTO, CA—Key legislation to protect patients from unfair health care costs faces crucial votes in the California legislature in the next week, beginning tomorrow in Assembly Health Committee.  The five bills, most of which have already passed one legislative chamber, include some of the most lobbied legislation this session, such as a measure to stop surprise medical bills and another to provide notice and disclosure on prescription drug costs.

> Keep Reading
News Release | CALPIRG | Health Care

More than 1 Million Californians Subject to “Unreasonable” Health Insurance Rate Hikes

“Health insurance rate review is an important tool for transparency and accountability, but it needs to be strengthened,” said CALPIRG Executive Director Emily Rusch. “It is unacceptable that so many consumers get stuck with health insurance rate hikes that are unreasonable and unjustified.”

> Keep Reading

Pages

News Release | CALPIRG | Health Care

Key Patient Rights Bills to Prevent Unfair Health Care Costs Face Crucial Votes This Week

SACRAMENTO, CA—Key legislation to protect patients from unfair health care costs faces crucial votes in the California legislature in the next week, beginning tomorrow in Assembly Health Committee.  The five bills, most of which have already passed one legislative chamber, include some of the most lobbied legislation this session, such as a measure to stop surprise medical bills and another to provide notice and disclosure on prescription drug costs.

> Keep Reading
News Release | CALPIRG | Health Care

More than 1 Million Californians Subject to “Unreasonable” Health Insurance Rate Hikes

“Health insurance rate review is an important tool for transparency and accountability, but it needs to be strengthened,” said CALPIRG Executive Director Emily Rusch. “It is unacceptable that so many consumers get stuck with health insurance rate hikes that are unreasonable and unjustified.”

> Keep Reading
Media Hit | Health Care

New Report Shows Rate Review Process Saved Californians $349M Since 2011

Californians have saved $349 million on health insurance under a rate review process established in 2011, according to a report from the California Public Interest Research Group. However, the report released last month also shows that almost one million Californians paid higher premiums due to rate hikes state officials deemed "unreasonable."

> Keep Reading
News Release | CALPIRG | Health Care

Health Insurance Rate Review Has Saved Californians $349 Million

 This report looks at the impacts and effects of the first three years of health insurance rate review in California, and makes policy recommendations to strengthen and expand the process to more extensively protect Californians from unjustified health insurance premium hikes.

> Keep Reading
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

Pages

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.

 

 

> 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.

> Keep Reading
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.”

> Keep Reading
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.

> Keep Reading
Report | CALPIRG Education Fund | Consumer Protection, Health Care

Your Price May Vary

New report finds that the price charged for common surgeries varies dramatically from one region to another within California.

> Keep Reading

Pages

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. 

> Keep Reading
Blog Post | Health Care

We're not done yet: Next steps for CA health care | Pedro Morillas

The Supreme Court has upheld the national health care law, and this is really good news for consumers.

> Keep Reading
Blog Post | Consumer Protection, Health Care

The Almighty Dollar before Health and Safety of Americans | Jon Fox

A recent op-ed is completely correct in its assumptions that anti-regulations rhetoric from the U.S. Chamber of Commerce is incessantly talking about regulations killing jobs and the economy.

> Keep Reading

Pages

View AllRSS Feed

Support us

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.

Consumer Alerts

Join our network and stay up to date on our campaigns, get important consumer updates and take action on critical issues.
Optional Member Code