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 Providence Health Plan's proposal to raise individual health insurance rates

Providence Health Plan’s 105,406 members with individual health insurance plans will see rate hikes of 29.6% on average, and as high as 72.3%, if the premium rate hike proposed by Providence goes forward. At the same time, the insurer is planning to scale back its service area drastically and no longer offer its plans in many regions of Oregon.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on Kaiser Foundation Health Plan of the Northwest's proposal to raise individual health insurance rates

Kaiser Foundation Health Plan of the Northwest’s 26,014 members with individual health insurance plans will see rate hikes of 14.5% on average, and as high as 22.05%, if the premium rate hike proposed by Kaiser goes forward.

> Keep Reading
Report | OSPIRG Foundation | Health Care

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

Regence BlueCross BlueShield’s 14,811 members with individual health insurance plans will see rate hikes of 17.9% on average, and as high as 36.1%, if the premium rate hike proposed by Regence 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 58,280 members with individual health insurance plans will see rate hikes of 32.3% on average, and as high as 84.2%,if the premium rate hike proposed by Moda goes forward.

> Keep Reading
Report | OSPIRG Foundation | Health Care

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

PacificSource Health Plans’ members with individual health insurance plans will see rate hikes of 15.2% on average, and as high as 25%, if the premium rate hike proposed by PacificSource goes forward. At the same time, the insurer is planning to scale back its service area drastically and no longer offer its plans in many regions of Oregon.

> Keep Reading

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News Release | OSPIRG Foundation | Health Care

Providence Customers May See Rates Rise As Much As 18.6%

 

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 posted today by Providence Health Plans goes forward. Many customers will also see increased out-of-pocket costs.

 

> Keep Reading
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

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Report | OSPIRG Foundation | Health Care

Comments on Regence BlueCross BlueShield's Proposal to Increase Individual Health Insurance Rates

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 proposed by Regence BlueCross BlueShield of Oregon goes forward.

OSPIRG Foundation's analysis finds problems and information gaps in the insurer's filing.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Raising the Bar: Strategies to contain cost and improve quality in Oregon’s health insurance exchange

Oregon’s new health insurance exchange has the potential to rein in the rising cost of health insurance and the underlying cost of care, while improving quality and giving consumers better choices. With the purchasing power of hundreds of thousands of Oregonians behind it, the exchange has the power to build better value for consumers, but it can only live up to its promise if it works from the beginning to raise the bar for health insurance in Oregon.

> Keep Reading
Report | OSPIRG Foundation | Health Care

At Stake: What's on the Line for Health Care Consumers in the Pending Supreme Court Case

The outcome of the U.S. Supreme Court’s ruling on the Affordable Care Act (ACA) will have far reaching impacts on consumers. The law is already working to improve the quality of care and reduce costs, with millions of Americans experiencing concrete improvements in their coverage. In this issue brief, we highlight the number of people the law has helped so far and the costs already saved to illustrate what’s at stake for Oregon consumers in the pending Supreme Court case.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on PacificSource's Small Business Rate Hike Proposal

PacificSource is proposing to increase rates 5.56% on average, affecting 35,224 Oregonians enrolled in small business plans. If approved, this rate increase will have wide ranging impacts. Most enrollees will see increases of between 6% and 10%. Some will see increases of up to 11.2%. Over 27% will see increases of between 8% and 14%.

 

> Keep Reading

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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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