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

News Release | OSPIRG | Health Care

OSPIRG's Jesse O'Brien Awarded "Health Care Value Advocate of the Year"

Today, OSPIRG Policy Director Jesse O’Brien was awarded “Health Care Value Advocate of the Year,” in recognition of his years of leadership advocating for policies and strategies to improve the value proposition of health care for consumers.

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Blog Post | Health Care

OPEN ENROLLMENT FOR 2018: WHAT YOU NEED TO KNOW | Jesse O'Brien

It’s that time again: Time to enroll in health insurance for next year. Health care has been a political football in Washington throughout the year, and there has been a lot of confusion and uncertainty about the future. With all of this background noise, it’s more important than ever to get the facts about how you and your family can get coverage that works for you. 

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Blog Post | Health Care

Accountability in Action: Rate Review Cuts More Than $100 Million from 2018 Health Insurance Premiums | Jesse Ellis O'Brien

Close scrutiny of proposed health insurance rates for 2018, along with a new state program to contain rate hikes, has cut more than $100 million from premiums for Oregon consumers. This brings the total in premium cut by Oregon’s rate review program to more than $280 million since 2010.

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News Release | OSPIRG Foundation | Health Care

Providence’s proposed 22.7% rate hike merits close scrutiny, underscores stakes for consumers in health reform debate

Providence Health Plan has proposed a rate hike of 22.7% on average—as high as 68.3% for some—on over 104,000 Oregonians. According to a new OSPIRG Foundation analysis released today, this rate hike proposal highlights not only the need for close scrutiny of health insurance rates, but also the high stakes for consumers in the federal health reform debate and the urgency of action to contain the rising cost of health care services.

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Report | OSPIRG Foundation | Health Care

OSPIRG Foundation Comments on the Providence Health Plan Proposal for Individual Health Rates Effective January 2018

Providence Health Plan’s 104,747 members with individual health insurance plans will see rate hikes of 22.7% on average, and as high as 68.3%, if the premium rate hike proposed by Providence goes forward.

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Media Hit | Health Care

Oregon slashes 2014 health insurance premium requests by as much as 35 percent

Oregonians who buy their own insurance have the first clear indication of what 2014 premiums will look like after state regulators Tuesday slashed carriers' rate requests by as much as 35 percent.

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Media Hit | Health Care

OSPIRG: 16 Health Insurance Companies Need To Justify Rates

An Oregon consumer group says the 16 companies that have proposed insurance rates for the state's new health exchange haven't offered adequate justification for prices.

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News Release | OSPIRG Foundation | Health Care

Proposed 2014 health insurance rates lack adequate justification

Sixteen Oregon health insurance companies have proposed their premium rates for next year, and according to new OSPIRG Foundation analysis released today, many have failed to adequately justify their prices.“With some insurers proposing rates twice as high as others for identical coverage, it is more critical than ever to scrutinize the basis for these rates,” said Jesse O’Brien, OSPIRG Foundation Health Care Advocate.

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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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Pages

Report | OSPIRG | Health Care

Should I Stay or Should I Go?

Tips for consumers deciding whether to keep their individual health insurance plan or switch to a new plan for 2014.

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Report | OSPIRG Foundation | Health Care

Accountability in Action

Close scrutiny of proposed health insurance premiums for 2014 has cut over $69 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 $155 million since 2010, providing more evidence that Oregon’s effort to create accountability for health insurers is starting to pay off.

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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.

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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.

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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.

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Blog Post | Health Care

A New Health Care Marketplace is Coming: Get Informed and Protect Yourself from Fraud | Jesse Ellis O'Brien

In just a few weeks, Oregon’s new health insurance marketplace, Cover Oregon, will be open for business. Any new program can be confusing for people at first, and scam artists and unscrupulous business ventures may try to take advantage of that confusion to rip off consumers. To make sure this doesn’t happen to you, be sure to check out these top tips for protecting yourself from fraud.

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Blog Post | Health Care

All you need to know about the 2014 health insurance rate decisions--in one chart! | Jesse Ellis O'Brien

Scrutiny of health insurance rates has cut over $69 million in waste and unjustified costs from 2014 premiums. This chart breaks it down for you.

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Blog Post | Health Care

Few Oregonians will receive health insurance rebate checks this year—Here’s why that’s a good thing | Jesse Ellis O'Brien

This summer, consumers and businesses nationwide will receive $500 million in rebates from health insurance companies. Only 1 in every 200 Oregonians will see a dime as a result of this program, and that’s great news for our state. Here’s why.

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Blog Post | Health Care

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

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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News Release | US PIRG Education Fund

A new analysis by the U.S. PIRG Education Fund and Frontier Group found that 8 percent of nursing homes nationwide as of Dec. 27 had a critical shortage of surgical-grade N95 masks, which are the best protection against spreading the virus. Additionally, 4 to 6 percent of nursing homes reported shortages in at least one other category of personal protective equipment.

News Release | OSPIRG

The maker of Humira, the world’s best-selling drug, faces a new legal challenge over alleged anticompetitive tactics. Monday, the U.S. Public Interest Research Group (U.S. PIRG) filed an amicus brief in the 7th Circuit Court of Appeals arguing that AbbVie’s strategies of reverse payment settlements and creating “patent thickets” have delayed the entry of biologically similar generic drugs (biosimilars) onto the market, costing Americans billions of dollars. 

News Release | OSPIRG Foundation

The coronavirus (COVID-19) pandemic is putting incredible stress on the U.S. medical system, including the equipment that is essential to diagnose and treat patients, such as ventilators. As that equipment is pressed into round-the-clock use, biomedical repair technicians face increasing pressure to maintain and repair all that equipment. However, in too many cases, manufacturers limit access to the essential tools and information these repair experts need. A new report by the OSPIRG Foundation, Hospital Repair Restrictions, details the challenges that medical professionals face as a result of device manufacturers setting up barriers to repair, and outlines steps to take to help hospitals. 

Report | OSPIRG Foundation

COVID-19 is putting incredible stress on the U.S. medical system, including the work of hospital biomedical repair technicians, known as biomeds or BMETs. These technicians are essential; hospitals need working equipment to diagnose and treat patients. But in some cases, manufacturers restrict access to what biomeds need.

News Release | OSPIRG

Oregon's Drug Price Transparency Program has released its first annual report.  The progam found that Oregonians, on average, pay five times the highest international price for prescriptions.  

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