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

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.

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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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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.

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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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News Release | CALPIRG Education Fund | Health Care

Anthem hikes rates 22%

Anthem Blue Cross is moving forward with a new rate hike on California consumers which will leave hundreds of thousands of individuals paying an average 22 percent more for insurance this year. Anthem had proposed raising rates 26 percent, but trimmed the rate to 22 percent after the California Department of Insurance (CDI) found the original increase unreasonable.

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Media Hit | Health Care

Letter to the Editor: Why healthcare costs so much

Wesley Samms' letter to the editor regarding the recent LA Times article: "Small surgery, huge markup," Business, Jan. 31

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News Release | CALPIRG Education Fund | Health Care

Aetna reduces rate following CALPIRG Ed Fund's review

 This week, Aetna Life Insurance Company announced plans to reduce its proposed increase in health insurance premiums. In November, CALPIRG Education Fund completed a review of the rate hike and recommended that the California Department of Insurance declare it unreasonable. Now, 68,000 small business employees impacted by the rate hike will see a significantly smaller increase in their health insurance premiums.

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News Release | CALPIRG Education Fund | Consumer Protection, Health Care

Hospitals in the Bay Area are Most Expensive in the State for Surgeries

A new report by CALPIRG Education Fund found large discrepancies between what California hospitals charge for common surgeries, which appear unrelated to quality of care.

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News Release | CALPIRG | Health Care

Statement by Pedro Morillas CALPIRG Legislative Director on U.S. Supreme Court Decision to Uphold Health Reform Law

Today’s decision is good news for consumers in California. Insurance companies can’t go back to the days of dropping your coverage once you become ill, or denying coverage to sick children. And beginning in 2014, the days of insurers being able to deny anyone coverage for “pre-existing conditions” will be history.

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Report | CALPIRG Education Fund | Health Care

Playing by Their Own Rules

This white paper examines the rules the drug companies have set for themselves, assesses whether they comply with the minimum requirements of SB 1765, and identifies aspects of the drug company rules that are deeply problematic.

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Report | CALPIRG Education Fund | Health Care

'Tis Always the Season for Giving

Desperate to rein in skyrocketing prescription drug costs, lawmakers, healthcare plans and individual consumers are taking a much closer look at the promotional practices of the pharmaceutical industry. One aspect that has come under heavy scrutiny is a marketing technique known as detailing. This white paper examines the mechanics and potential harms of pharmaceutical detailing, describes the steps that have been taken to address those problems, and explores policy options for addressing the issue.

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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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