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 | Health Care

Our Statement on Senate Health Care Bill

Statement by Jesse Ellis O’Brien, CALPIRG Health Care Advocate, on public release of the “Better Care Reconciliation Act.” 

> Keep Reading
News Release | Health Care

Great News for Consumers: Anthem Drops Bid to Take Over Cigna

This morning, health insurance giant Anthem dropped its troubled bid to take over one of its top competitors, Cigna. A February district court decision to block the proposed merger on anti-trust grounds was recently upheld by the DC Circuit Court of Appeals, but with Anthem’s decision today, this anti-competitive takeover bid is finally laid to rest. This development comes after months of work by CALPIRG and a broad coalition of consumer and health care groups, urging close scrutiny of the merger from state and federal regulators and raising questions and concerns about the potential impact on consumers.

> Keep Reading
News Release | U.S. PIRG | Health Care

Our Statement on House Passage of the American Health Care Act

Today’s House vote is a big step in the wrong direction for American consumers and the American health care system. It’s no secret that there are plenty of problems with health care in America, but the AHCA in its current form not only won’t address the real problems in our health care system—it is likely to make them worse.

> Keep Reading
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

Pages

News Release | Health Care

Our Statement on Senate Health Care Bill

Statement by Jesse Ellis O’Brien, CALPIRG Health Care Advocate, on public release of the “Better Care Reconciliation Act.” 

> Keep Reading
News Release | Health Care

Great News for Consumers: Anthem Drops Bid to Take Over Cigna

This morning, health insurance giant Anthem dropped its troubled bid to take over one of its top competitors, Cigna. A February district court decision to block the proposed merger on anti-trust grounds was recently upheld by the DC Circuit Court of Appeals, but with Anthem’s decision today, this anti-competitive takeover bid is finally laid to rest. This development comes after months of work by CALPIRG and a broad coalition of consumer and health care groups, urging close scrutiny of the merger from state and federal regulators and raising questions and concerns about the potential impact on consumers.

> Keep Reading
News Release | U.S. PIRG | Health Care

Our Statement on House Passage of the American Health Care Act

Today’s House vote is a big step in the wrong direction for American consumers and the American health care system. It’s no secret that there are plenty of problems with health care in America, but the AHCA in its current form not only won’t address the real problems in our health care system—it is likely to make them worse.

> Keep Reading
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
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

Pages

Result | Health Care

Consumer-Friendly Health Care

In the fall of 2015, the state Legislature passed a series of CALPIRG-backed bills designed to help promote a more consumer-friendly and affordable health care system in California. State Bill (SB) 137 will give consumers accurate, up-to-date information about their health plan’s network; Assembly Bill (AB) 339 will ensure people with chronic health conditions are not discriminated against by insurers; AB 1305 will limit deductibles and annual out-of-pocket maximums for individual members of families; and SB 546 will require health insurance companies to justify rate increases for large employers’ health insurance plans.

> Keep Reading
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.

> Keep Reading
Result | Health Care

Pro-consumer Health Care Reform

CALPIRG’s advocacy helped ensure the health care law will bring down costs by setting up a competitive health insurance marketplace. In 2010, California became the first state in the country to begin setting up our state health insurance exchange.

> Keep Reading
Result | Health Care

Fighting To Make Health Care Affordable

Thanks to a new CALPIRG-backed law, insurance companies actually have to justify rate hikes to the public, bringing some much-needed accountability. Thanks in part to the new law — and public pressure, including 1,200 public comments from CALPIRG supporters — Anthem Blue Cross and Blue Shield of California both backed off of double-digit rate hikes.

> Keep Reading
Report | CALPIRG | Health Care

California Health Insurance Rate Review: the First Five Years

In this brief, CALPIRG examines the implementation of rate review in California, and the results it has achieved for consumers and small employers across the state. Our analysis includes posted rate filings that were scheduled to go into effect between January 1, 2011 and January 1, 2016.

> Keep Reading
Report | CALPIRG Education Fund | Health Care

Health Insurance Rate Watch: Comments on the Anthem Blue Cross Life and Health Insurance Company Proposal

Anthem Blue Cross Life and Health Insurance Company has proposed increasing rates on April 1, 2015 for nearly170,000 people who obtain their health insurance through 28 grandfathered plans offered by Anthem. CALPIRG Education Fund's Health Insurance Rate Watch project reviewed Anthem’s filing documents and found that Anthem failed to provide adequate justification for its proposed rate increase. 

> Keep Reading
Report | CALPIRG Education Fund | Health Care

Health Insurance Rate Watch: Comments on Blue Shield Rate Filing

Blue Shield has proposed rate increases as high as 9.7 percent for policyholders in its “grandfathered” health insurance plans, those that were established before the Affordable Care Act was signed into law, affecting 40,070 Californians currently covered under the plans. CALPIRG Education Fund's Health Insurance Rate Watch project reviewed Blue Shield's rate filing and raised a number of questions and concerns to the California Department of Insurance. 

> Keep Reading
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.

> Keep Reading
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.

> Keep Reading

Pages

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
Blog Post | Health Care

A Setback for Consumers Worried about High Prescription Drug Costs | Emily Rusch

Yesterday a CALPIRG-backed bill that would have required the prescription drug companies to disclose some of the factors behind their skyrocketing prices failed to pass out of the Assembly Health Committee. The pharmaceutical companies had heavily lobbied against the bill. 

> Keep Reading
Blog Post | Consumer Protection, Health Care

Pro-Consumer Healthcare Bills Pass Legislature, Await Governor's Signature | Jason Pfeifle

Late last week the California State Legislature passed a series of bills designed to help prevent unfair medical charges, excessive health insurance rates, and misleading information about access to health care providers. Together these bills, if signed into law by Governor Jerry Brown, will help promote a more consumer friendly and affordable health care system in California.

> Keep Reading
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

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