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

Blog Post | Health Care

Open enrollment for 2017: What you need to know | Jesse Ellis O'Brien

It’s that time again: Time to enroll in health insurance for 2017. Here’s our guide to Oregon’s open enrollment period, which starts November 1.

> Keep Reading
Blog Post | Health Care

The Last Word on Oregon’s 2017 Health Insurance Rates and Coverage Options | Jesse Ellis O'Brien

An update on the latest developments with health insurance rates for 2017 and what they mean for the future of healthcare in our state.

> Keep Reading
Blog Post | Health Care

Oregon awarded a “B” on health care price transparency—but the state is still failing consumers | Jesse O'Brien

OSPIRG has been pushing for years to increase access to accurate, actionable health care price information for Oregon consumers. So you’d think we would be celebrating when a national scorecard from the transparency advocates at Catalyst for Payment Reform recently gave Oregon a “B” rating—up from an “F” in every prior year—for progress toward making price information more widely available. Unfortunately, there’s much less here than meets the eye.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Proposed health insurance rate hikes up to 32.3% merit close scrutiny, raise stakes for containing rising health care costs

Many of Oregon’s biggest health insurers have proposed large double-digit rate hikes for 2017, and according to new OSPIRG Foundation analysis released today, these proposals highlight not only the need for close scrutiny of health insurance rates, but also the urgency of action to contain the rising cost of health care services.

> Keep Reading
Blog Post | Health Care

Proposed Health Insurance Rates for 2017: What You Need to Know | Jesse Ellis O'Brien

Here’s the skinny on OSPIRG Foundation’s new analysis of 2017 rates proposed by five Oregon insurers—Kaiser, Moda, PacificSource, Providence and Regence. There’s some good news, some concerning news, and some very concerning news, but the best news of all is that thanks to Oregon’s health insurance rate review process, the insurers don’t get the last word.

> Keep Reading

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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.

> Keep Reading
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.

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Regence Rate Hike Not Justified

Regence BlueCross BlueShield of Oregon’s proposal to raise rates for Oregonians with individual health insurance plans does not measure up, according to a new OSPIRG Foundation analysis.

> Keep Reading
Media Hit | Health Care

Regence BlueCross BlueShield defends proposed rate hike at Salem hearing

Escalating medical and prescription drug costs have given Regence BlueCross BlueShield executives little choice but to raise rates an average 9.6 percent for people who buy their own insurance, an executive told Oregon insurance regulators Monday.

Jesse Ellis O'Brien of the OSPIRG Foundation said Oregonians will face less choice and more costs as a result of the proposal.

> Keep Reading
Media Hit | Health Care

Regence Reduces Payments to Healthcare Professionals

July 26, 2012 -- Physicians and other healthcare professionals are being hit with a rate reduction from Regence BlueCross BlueShield on October 1, while the insurer is asking the Insurance Division to approve a 9.6 percent increase for roughly 53,000 people who buy their own coverage. A public hearing on that rate request will be held next Monday at 3 p.m. in Salem.

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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.

 

> Keep Reading
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.

> Keep Reading
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

Here’s that Rx refill you didn’t order | Jesse 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.

> Keep Reading
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.

> Keep Reading
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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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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