Health Insurance Rate Watch Project

OSPIRG Foundation’s Health Insurance Rate Watch Project is conducting in-depth analysis of insurers' rate hike requests, sharing our findings with state officials and the general public, and encouraging the public to participate in Oregon’s rate review process.

Scrutinizing Health Insurance Rate Hikes

Oregonians have reached a breaking point on health care costs: At the current rate, the cost of covering the average Oregon family could rise to more than $21,000 a year by 2019. [1] At the same time, studies show that a third or more of every dollar we spend on health care is wasted on something that does not improve our health. [2]

Health insurance companies could be lowering costs by cutting administrative bloat, driving a hard bargain with hospitals on prices, paying doctors to keep people healthy rather than to order expensive treatments, and passing on those savings to customers. But too often, they just keep raising rates on their customers without doing these things. [3]

Thankfully, state officials, led by the Oregon Insurance Division, have significantly stepped up their scrutiny of health insurers’ rate hike requests. Since 2010, it made cuts to a majority of requests, cutting over $179 million in waste. [4] Highlights include:

  • Regence BlueCross BlueShield (2011): $12.5 million in waste cut, over $200 per person, when the state knocked back a 22% proposed increase nearly in half.
     
  • Providence (2013): $17.9 million in waste cut when the state trimmed back proposed rates by over 20%.

OSPIRG Foundation’s Health Insurance Rate Watch Project is doing our part by conducting in-depth analysis of insurers' rate hike requests, sharing our findings with state officials and the general public, and encouraging the public to participate in Oregon’s rate review process.

Our work is supported in part by a grant from the Robert Wood Johnson Foundation, and from a grant of federal funds by the Oregon Department of Consumer and Business Services. The project is supported by Grant Number IPRPR0057A from Department of Health and Human Services Office of Consumer Information and Insurance Oversight (CCIIO). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CCIIO.

Learn more about Oregon's 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

Our project is guided by an Advisory Board of community leaders and experts, including:

  • Jerry Cohen of AARP-Oregon
  • Jim Houser of Hawthorne Auto Clinic.

[1] For employer coverage, based on 2009-2014 trends. Henry J. Kaiser Family Foundation. Employee Health Benefits: 2014 Summary of Findings

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

[3] For some real-life examples of cutting waste out of health care, see Atul Gawande's "Overkill," The New Yorker, May 2015.

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

Issue updates

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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Blog Post | Health Care

Tax Season and Health Care: What You Need to Know | Jesse Ellis O'Brien

Tax season is here, and many Oregonians may have questions about new tax forms and provisions, including health premium tax credits and the new requirement to purchase health insurance. Here’s what you need to know.

> Keep Reading
Blog Post | Health Care

Open Enrollment: Here’s What You Need to Know | Jesse Ellis O'Brien

The countdown is on for enrolling in health insurance for 2015. With all of the changes coming to health care in Oregon, it’s more important than ever to get the facts about what’s happening and how you and your family can get coverage that works for you. Here’s our guide to Oregon’s open enrollment period, which starts November 15.

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News Release | OSPIRG Foundation | Health Care

Over $24 Million in Waste Cut from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses, according to a new OSPIRG Foundation report released today. The cuts come after OSPIRG Foundation’s analysis questioned the justifications of four major rate proposals. Taken together with cuts made since new standards were implemented, state officials have required insurers to cut $179 million in waste since 2010.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Accountability in Action: Rate Review Cuts Over $24 Million in Waste from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses. This brings the total waste cut by Oregon’s rate review program to over $179 million since 2010.

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News Release | OSPIRG Foundation | Health Care

Regence Rate Hike To Reach 16.4% for Some Customers

More than 52,000 Oregonians with individual health insurance plans will see rate hikes of 9.6% on average, and as high as 16.4%, if the premium rate hike posted today by Regence BlueCross BlueShield goes forward. At the same time, customers in lower-deductible plans will face out-of-pocket costs starting at $2,500 before coverage kicks in, and consumers in the Portland metro area may need to change providers.

> Keep Reading
Media Hit | Health Care

Portland-area Regence BlueCross BlueShield individual members could see rate hikes as high as 15.3 percent

Individual members of Regence BlueCross BlueShield could see an average 9.6-percent rate increase statewide, requested by the insurer months after announcing network changes to cut costs.

> Keep Reading
News Release | OSPIRG | Health Care

Supreme Court Upholds Affordable Care Act

Today’s decision is good news for consumers in Oregon. Now it’s time for Oregon leaders to move forward on the next steps, and make sure health reform delivers lower costs and better quality coverage.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Health Net Rate Hike Not Justified

If approved, the rate increase would impact 38,492 Oregonians with coverage through a small business employer. Of those enrollees, 14,298 would see rates rise between 11% and 30%.

 

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Health Insurance Rates to Rise 8-14% for Many Oregon Small Businesses

If approved, the insurer will raise rates 5.56% on average beginning in July, affecting 35,224 Oregonians enrolled in coverage through a small business employer.

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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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Report | OSPIRG Foundation | Health Care

Advancing Accountability, Cutting Health Care Waste

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 a new OSPIRG Foundation report. 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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Report | OSPIRG Foundation | Health Care

Comments on PacificSource Health Plans Proposal to Increase Small Group Health Insurance Rates

PacificSource Health Plans is proposing a rate increase on small business plans that will affect over 36,000 Oregonians, with an average increase of 8.62% and ranging up to 14.5% for some customers. If approved, the increase would go into effect January 1, 2013.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on Providence Health Plans Proposal to Increase Individual Health Insurance Rates

More than 12,000 Oregonians with individual health insurance plans will see rate hikes of 15.7% on average, and as high as 18.6%, if the premium rate hike proposed by Providence Health Plans goes forward. OSPIRG Foundation's analysis raises questions about the insurer's justification for the rate increase.

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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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Blog Post | Health Care

Regence alters course in response to consumer outcry | Jesse Ellis O'Brien

It's a difficult and confusing time to be a Regence customer. After announcing drastic network cutbacks last month, Regence altered course today in the wake of widespread criticism. But Regence customers can still expect to be paying more and getting less.

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Blog Post | Health Care

Regence Rate Increase Hearing

Health insurance premiums are going up again. The latest request for a rate hike came from Regence for their small group plans. The average increase requested over the next year will be 8%, but some businesses will see increases in excess of 15%. At OSPIRG Foundation, we’re concerned that Regence has not adequately justified this increase request.

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