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

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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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. 

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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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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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Media Hit | Health Care

Drug Makers Stall Generics With “Pay For Delay” Says CALPIRG

The California Public Interest Research Group or CALPIRG has released details on what it says is a practice that leads to prescription drug price inflation. CALPIRG calls it “pay for delay.” CALPIRG says the practice of keeping generics off the market makes consumers pay more for medications that treat conditions like cancer and high cholesterol.

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Media Hit | Health Care

CALPIRG study claims drug companies hold back generic meds

SACRAMENTO, Calif. (KCRA) —A study by a public interest group found Californians have overpaid for medications because brand-made drugs were delayed from reaching pharmacies.

Read more: http://www.kcra.com/news/calpirg-study-claims-drug-companies-hold-back-generic-meds/-/11797728/20945964/-/uh9rdr/-/index.html#ixzz2YrSJnikK

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News Release | CALPIRG | Health Care

Twenty Top Generic Drugs Delayed By Industry Payoffs

The report, “Top Twenty Pay-for-Delay Drugs: How Drug Industry Payoffs Delay Generics, Inflate Prices and Hurt Consumers” reveals that these drugs were subject to an industry practice called “pay for delay,” in which brand name pharmaceutical companies pay off generic drug manufacturers to keep lower cost equivalents off the market, forcing consumers to pay higher brand-name drug prices.

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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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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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