Health Insurance Rate Watch Project

OSPIRG’s Health Insurance Rate Watch Project pushes health insurers to do more to cut waste and focus on prevention before they raise premiums. 

Cutting waste from insurance premiums

Health care still costs more than it should. One study estimates that in 2009, $765 billion, or one-third of all health care spending, was wasted on things that did not make us healthier. [1] Some of that estimated waste included:

  • Overinflated medical prices: $105 billion in waste. Recently, hospitals have been caught charging outrageous prices, such as $1000 for one toothbrush and $140 for a single Tylenol. [2]
  • Duplicative treatments: $8 billion in waste. This includes the extra costs of having to get the same x-ray or MRI twice because health care is poorly coordinated.
  • Excessive administrative costs and paperwork: $190 billion in waste. 

Far too often, insurers simply pass those costs along to us in the form of higher premiums. 

So OSPIRG pushes back to make sure health insurance companies do more to cut waste before they raise premiums. Close scrutiny of rate hike proposals already helped cut over 179 million dollars from health insurance premiums in Oregon. [3] Now we want to make sure that insurers do even more to bring down costs: by focusing on keeping patients healthy instead of only paying for treatments once they get sick; actively negotiating for better deals from hospitals; and doing more to cut waste.

Unfortunately, some health insurance companies are spending millions to maintain their influence in Salem. But when we’ve brought public pressure to bear on unjustified rate increases, we’ve seen results, so join us!

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[1] Institute of Medicine of the National Academies, Feb. 2011, The Healthcare Imperative: Lowering Costs and Improving Outcomes: infographic and report

[2] CNN, March 2010, Prescription for waste: $1000 toothbrush. See also New York Times, Dec. 2013, As Hospital Prices Soar, a Stitch Tops $500.

[3] OSPIRG Foundation, September 2014, Accountability in Action.

Learn more about Oregon's health insurance rate review process and sign up to get notified about major rate proposals at the Oregon Insurance Division's consumer-friendly website, www.oregonhealthrates.org

Issue updates

Report | OSPIRG Foundation | Health Care

Comments on PacificSource Health Plan's proposal to raise individual health insurance rates

PacificSource Health Plan members with individual health insurance plans will see rate hikes of 42.7% on average, and as high as 60.4%, if the premium rate hike proposed by PacificSource goes forward. PacificSource’s increase is the largest proposed by a major health insurance carrier in Oregon’s individual market since 2010, when new rules heightening scrutiny of health insurance rates were implemented.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on Regence BlueCross BlueShield of Oregon's proposal to raise individual health insurance rates

Regence BlueCross BlueShield’s membership of more than 24,000 Oregonians with individual health insurance plans will see rate hikes of 12.3% on average, if the premium rate hike proposed by Regence goes forward. Some Regence members in transitional plans that will be discontinued at the end of the current year, which do not include the consumer protections of the federal health reform law, may see increases of up to 235% if they stick with Regence.

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Report | OSPIRG Foundation | Health Care

Comments on LifeWise Health Plan of Oregon's proposal to raise individual health insurance rates

LifeWise Health Plan of Oregon’s 26,405 members with individual health insurance plans will see rate hikes of 37.2%on average, and as high as 45%, if the premium rate hike proposed by LifeWise goes forward.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on Moda Health Plan's proposal to raise individual health insurance rates

Moda Health Plan’s membership of more than 102,000 Oregonians with individual health insurance plans will see rate hikes of 25.6% on average, and as high as 54.12%, if the premium rate hike proposed by Moda goes forward. Moda currently has the largest market share in Oregon’s Individual market. Moda’s increase is the largest proposed by the dominant carrier in the individual market since 2010, when new rules heightening scrutiny of health insurance rates were implemented.

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News Release | OSPIRG | Health Care

OSPIRG applauds passage of landmark health insurance network consumer protection legislation

House Bill 2468 will enable state regulators hold insurers accountable for delivering access to needed health care services through provider networks. The bill passed the Oregon Senate today and is on its way to Gov. Brown’s desk.

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News Release | OSPIRG Foundation | Health Care

$80 Million In Health Insurance Waste Cut Since 2010

Since 2010, close scrutiny of health insurance rate hikes has cut over $80 million in waste and unjustified costs from health insurance premiums in Oregon, according to an OSPIRG Foundation report released today. The report also identifies changes to Oregon’s rate review program that would effectively tackle the biggest driver of costs: waste in the health care delivery system.

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Media Hit | Health Care

Public comment sought on rules for Oregon health insurance exchange

State officials are holding a hearing Wednesday to receive public comment on rules for the state's health insurance exchange -- essentially an online marketplace for consumers called for by federal health reforms.

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Media Hit | Health Care

Malpractice Legislation Nearly Ready to See Daylight

After months of negotiations between trial lawyers and physicians, legislators are optimistic about reaching a consensus on medical malpractice reform when they gather in Salem next month. All along the goal has been to find a way of reducing lawsuits while creating a safer patient environment.

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Media Hit | Health Care

What's Next on Health Care Costs?

Now that the election is over, talk has turned to the need to work together and get results for America. It's a tall order, and on the polarized issue of health care, it may seem at first like an impossible task. But I am hopeful that we can make significant progress together.

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News Release | OSPIRG Foundation | Health Care

Regence rate hike scaled back

State officials have decided to trim Regence BlueCross BlueShield of Oregon’s proposal to raise rates for more than 52,000 Oregonians with individual health insurance plans. Instead of the 9.6% rate hike proposed, the Oregon Insurance Division approved an 8.9% average increase, with some consumers seeing increases as high as 15.6%. Regence does not appear to have resolved many of the problems identified in OSPIRG Foundation's analysis of their proposal. In addition, elements of the decision were based on information that was not made available to the public.

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Report | OSPIRG Foundation | Health Care

Comment on Providence Health Plan's Proposed Individual Health Insurance Rates

Providence Health Plan has proposed premium rates for its individual and family plans for 2014. The insurer initially filed for significantly higher rates than Oregon’s other top insurance companies,   but then proposed lowering the rates. Doing so would bring the rates in line with those of competing insurers. OSPIRG Foundation's analysis of Providence's initial filing and the supplemental information provided raises some concerns about the insurer's proposal and its justification.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comment on Kaiser Foundation Health Plan's Proposed Individual Health Insurance Rates

Kaiser Foundation Health Plan of the Northwest has proposed premium rates for its individual and family plans for 2014. Since its initial rate filing, the insurer has submitted a proposal to reduce those rates. OSPIRG Foundation's analysis of Kaiser’s initial filing and the supplemental information provided raises some concerns about the insurer's proposal and its justification.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comment on BridgeSpan Health Company's Proposed Individual Health Insurance Rates

BridgeSpan Health Company—a new health insurer affiliated with Regence BlueCross BlueShield of Oregon through a parent company, Cambia Health Solutions—has proposed premium rates for its individual and family plans for 2014. OSPIRG Foundation's analysis raises questions about the insurer's justification for the proposal, and about BridgeSpan's efforts to reduce costs by cutting waste and focusing on prevention.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on LifeWise Health Plan's Proposal for Individual Health Insurance Rates

LifeWise Health Plan of Oregon has proposed premium rates for its individual and family plans for 2014. After careful analysis of LifeWise’s initial filing and the supplemental information provided, OSPIRG Foundation's analysis questions whether the insurer has provided sufficient information to evaluate the justification for their proposed rate.

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Report | OSPIRG Foundation | Health Care

Comment on Moda Health Plan's Proposed Individual Health Insurance Rates

 

Moda Health Plan—formerly known as ODS Health Plan—has proposed premium rates for its individual and family plans for 2014. Moda’s proposed rates are the lowest filed for an insurer in Oregon’s Individual market. While Moda’s product is inexpensive relative to the competition, it remains critical to examine the justification for their rate.

 

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Blog Post | Health Care

Competition and Transparency Bring Down Health Insurance Costs—Here’s the Proof | Jesse Ellis O'Brien

Something remarkable just happened to health insurance costs here in Oregon. Last week, after the state’s health insurers posted their proposed premium rates for next year, two insurers publicly reversed course and moved to cut their prices.

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Blog Post | Health Care

The Supreme Court and the High Cost of Rx Drugs | Jesse Ellis O'Brien

Everyone knows prescription drugs cost more than they should. But many people are surprised to learn about one of the key ways drug companies keep prices high: Paying off competitors to keep generics off the market.

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Blog Post | Health Care

A new way of shopping for health insurance gets a trial run | Jesse Ellis O'Brien

 

For the first time, the Oregon Health Insurance Exchange brought in consumers and outside experts to review their designs for their online marketplace. I was there, and here’s some of what I learned.

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Blog Post | Health Care

Here’s that Rx refill you didn’t order | Jesse Ellis O'Brien

Is your pharmacy refilling your prescription without your knowledge or approval, and billing your insurance company for the cost? If so, it’s the latest example of waste we shouldn't tolerate in our health care system.

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Blog Post | Health Care

A wake-up call on health insurance costs | Jesse Ellis O'Brien

Governor Kitzhaber’s office just released a report that should serve as a wake-up call for everyone in Oregon who is affected by the rising cost of health insurance.

This report just underlines what we’ve been saying all along—that it’s time to get serious about the cost of health care.

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