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: 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.

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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. 

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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.

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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.

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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. 

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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

Pay for Delay

Dr. Michael Wilkes from the University of California, Davis school of Medicine talks about pay-for-delay on his KCRW show "Second Opinion" 

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Media Hit | Health Care

Consumers are paying more money for certain drugs

The California Public Interest Research Group  released the report on  a practice critics call "Pay for delay."   That's when brand name drug companies pay off generic manufacturers to delay putting generic versions on the market.  As a result, consumers end up paying a lot more. The study found in some cases hundreds of dollars more were spent on meds used to treat cancer,  depression and heart disease. 

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Media Hit | Health Care

Pharmaceutical companies pay to delay generics

The report, from the California Public Interest Research Group and Community Catalyst, a nonprofit advocate for affordable health care, said pay-for-delay deals enable companies to continue to sell their brand-name drugs at high prices well after their original patents have expired.

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Report | CALPIRG Education Fund | Health Care

The Cost of Repeal

On March 23, 2010, after a long congressional debate, President Barack Obama signed into law comprehensive federal health care reform legislation, known as the Affordable Care Act or ACA. But the enactment of the law did not end the debate. Even the law’s strongest proponents acknowledge the need for improvements. And across the country, state legislators and Governors have been urged to slow or stop work on implementation of key provisions. The courts are considering legal challenges to the law.

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Report | CALPIRG Education Fund | Health Care

Delivering on the Promise

The recently passed federal health care reform law will make significant changes in how health insurance and health care work for consumers, businesses, and local and state governments, as well as how insurers and providers operate.  But whether Americans experience improved care, lower costs and greater access depends largely on what happens next. This guide has been written to assist state policymakers and advocates as they engage with the numerous issues and opportunities presented by the new law. 

 

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Report | CALPIRG Education Fund | Health Care

Keeping Insurers Honest

Of all the problems affecting California’s health care system, none is more immediate than the skyrocketing premiums consumers face year after year.  Understandably, then, Anthem Blue Cross of California’s recent proposal to hike rates on its customers by up to 39 percent galvanized an angry public.  A majority of states – at least 30 – have some form of protection, called “rate review.”  And their experience proves that giving regulators the power to reject proposed premium increases that cannot be justified on the facts helps police insurer behavior and lowers costs. 

 

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Report | CALPIRG Education Fund | Health Care

Uncovered: How California's health care system fails young people

This report explores the under-appreciated problems facing American youth in our health care system. It examines the status quo, looking particularly at the coverage crisis affecting young people, the consequences a lack of quality coverage can impose on their lives, and the inadequacy of the school-based policies many universities offer their students.

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Report | CALPIRG Education Fund | Health Care

The Small Business Dilemma

When it comes to health care, American small business owners are getting a raw deal. While the current insurance marketplace offers some options to larger employers, it too often leaves small business owners on the outside looking in. They face unpredictable changes in costs, and far too often they are forced to choose between covering employees and the very survival of their businesses.

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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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