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

Top Twenty Pay-For-Delay Drugs

Californians with cancer, heart disease, epilepsy and other conditions have been forced to pay an average of 10 times more than necessary for at least 20 blockbuster drugs, according to a report released today by California Public Interest Research Group (CALPIRG) and Community Catalyst.

 

 

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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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News Release | CALPIRG Education Fund | Health Care

Covered California Announces New Plans and Rates for 2014

“Today’s announcement is the exciting next step in ensuring that Californians can access affordable and reliable heath care coverage,” said Jon Fox.

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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. 

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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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News Release | CALPIRG | Health Care

Supreme Court to Hear Challenges on Health Reform

The Supreme Court’s decision to hear arguments on the new health reform law means that soon, the question of its constitutionality will be settled, allowing states and policymakers to focus on lowering costs for consumers without being distracted by counterproductive lawsuits. Upholding the law would be a clear win for consumers, while a bad ruling would pull the rug out from under states and consumers.

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News Release | CALPIRG Education Fund | Health Care

California's Health Exchange on Track to Lower Costs for Consumers

California’s health insurance exchange has the potential to be a national leader in delivering better value for consumers, according to Making the Grade, a new report by CALPIRG Education Fund. 

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News Release | CALPIRG | Health Care

Blue Shield Refund Shows Need for Stronger Rate Review

Blue Shield of California followed through on its promise to cap profits at 2% of revenue resulting in a refund of $295 million to policyholders.  This action comes in the midst of increased public scrutiny about major premium increases from several of California’s major health insurers and a push for legislation that would give regulators the authority to reject or reduce unjustified rate hikes. 

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News Release | CALPIRG | Health Care

Governor Signs Health Care Bill to Limit Insurers' Overhead

Governor Brown signed a new health care bill into law that will require insurers to use a higher percentage of consumers’ premiums for actual health care costs.   If insurers fail to meet this target consumers will be eligible for an annual rebate. 

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Media Hit | Health Care

Associated Press: Bill to regulate health insurance rates is pulled

The author of a bill that would have given California regulators the power to reject health insurance rate increases said Wednesday he has pulled it from consideration this year.

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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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