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

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

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.

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Blog Post | Health Care

PIRG applauds decisions blocking health insurance mega-mergers

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.

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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.

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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.”

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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."

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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.

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Report | CALPIRG Education Fund | Health Care

At Stake: What’s on the Line for Health Care Consumers in the Pending Supreme Court Case

The outcome of the U.S. Supreme Court’s ruling on the Affordable Care Act (ACA) will have far reaching impacts on consumers. The law is already working to improve the quality of care and reduce costs, with millions of Americans experiencing concrete improvements in their coverage.

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Report | CALPIRG Education Fund | Health Care

Making the Grade

Health care exchanges, authorized by 2010’s health reform law, offer the states the chance to address the twin problems of cost and quality, and help consumers get a fair shake when buying insurance. 

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Report | CALPIRG Education Fund | Health Care

Building a Better Health Care Marketplace

The creation of a new health insurance exchange offers our state the chance to build a better marketplace for health care.  The exchange can help individuals and small businesses by increasing competition and improving choices in the state’s insurance market.  By providing better options and better information, and negotiating on behalf of its enrollees, the exchange can level the playing field for consumers.

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Report | CALPIRG Education Fund | Health Care

Building a Better Health Care Marketplace Brief #7

The exchange is a store where consumers can buy health insurance products – and anyone who’s worked retail knows that however much work has gone into crafting strong policies and building an efficient back-office, if customers  can’t understand, compare and choose the products that are right for them, it just won’t work.  

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Report | CALPIRG Education Fund | Health Care

Building a Better Health Care Marketplace: Policy Briefing #6

Medicaid will see its eligibility significantly increased in 2014, the same year the state exchange will open its doors. 

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