Prop 45: Approval of Healthcare Insurance Rate Changes

Put on the Ballot by Petition Signatures

40.2% YES
59.8% NO

Argument in Support of Proposition 45

Proposition 45 Will Stop Excessive Health Insurance Rate Hikes

Health insurance premiums have risen 185% since 2002, five times the rate of inflation.

Even when premium increases are found to be unreasonable, no one in California has the power to stop them!

That's why Californians recently faced $250 million in rate hikes that state regulators found to be "unreasonable" but could not stop.

Proposition 45 requires health insurance companies to open their books and publicly justify rate hikes, under penalty of perjury, before they can raise premiums for 5.8 million individual consumers and small business owners.

Proposition 45 will:

  • Require disclosure by making public the documents filed by insurers to justify rate increases.
  • Promote transparency by allowing public hearings and the right to challenge unjustified premium increases.
  • Create accountability by giving the insurance commissioner authority to reject excessive rate increases and order refunds.

Proposition 45 protects patients from health insurance company profiteering. Unaffordable insurance leads to unpaid medical bills, the leading cause of personal bankruptcy. Nearly 40% of Americans skip doctor visits or recommended care due to the cost.

Proposition 45 will stop health insurance company price gouging and lower health insurance premiums.

How do we know?

Proposition 45 Extends The Protections Of Another Voter Approved Initiative That Has Saved Consumers Billions

California auto and home insurance companies have been required to justify rate hikes and get permission to raise premiums since 1988.

Since voters enacted these insurance protections (Proposition 103), California is the only state in the nation where auto insurance rates went down over two decades! The Consumer Federation of America reported in November 2013 that

California's auto insurance rate regulations have saved California consumers $102 billion by preventing excessive rate increases. Proposition 45 applies these rules to health insurers.

A nationally recognized actuary, who has reviewed health insurance rates in other states, and Consumer Watchdog estimate that Proposition 45 could save Californians $200 million or more per year.

Proposition 45 Is Needed Even More Now That Everyone Is Required To Have Health Insurance

The federal healthcare law does not give regulators the power to stop excessive rate hikes.

As the Los Angeles Times editorial board said, "As of 2014, the healthcare reform law will require all adult Americans to obtain health coverage. Regulators ought to have the power to stop insurers from gouging that captive market."

The San Jose Mercury News editorialized: "California should join the majority of states across the nation, 36 of 50, that have authority to control health insurance rate hikes."

California's big health insurance companies have already contributed $25.4 million to stop Proposition 45. They blocked legislation for greater transparency and accountability like Proposition 45 for a decade. They want to continue charging you as much as they want. Don't be misled.

Proposition 45 will lower healthcare costs by preventing health insurance companies from jacking up rates and passing on unreasonable costs to consumers.

Join us in support of Proposition 45 to save money on health insurance. Learn more:

Thank you.

Deborah Burger, President California Nurses Association Jamie Court, President Consumer Watchdog
Dolores Huerta, Civil Rights Leader

Arguments printed on this page are the opinions of the authors and have not been checked for accuracy by any official agency.

Rebuttal to Argument in Support of Proposition 45

Prop. 45 isn't about controlling health insurance rates — because California just launched a new independent commission this year responsible for controlling health insurance rates and expanding coverage.

Instead, Prop. 45 is really about who has power over health care: the independent commission, or one politician who can take campaign contributions from special interests like insurance companies and trial lawyers.

Prop. 45 — Undermines California's New Independent Commission

The independent commission is working to control costs, providing what the Los Angeles Times described as "Good News About Health Costs."

But the special interests backing Prop. 45 have a different agenda: GIVE ENORMOUS POWER over health insurance benefits and rates to a single Sacramento politician.

This power grab would sabotage the independent commission with bureaucratic conflicts, lengthy delays and higher costs for consumers — and give powerful special interests more influence over health care.

Prop. 45 — Another flawed, costly, deceptive initiative

  • Under Prop. 45, ONE POLITICIAN COULD CONTROL THE BENEFITS AND TREATMENT OPTIONS our insurance covers. We shouldn't expose treatment decisions to some politician's political agenda.
  • Increases State Administrative COSTS TENS OF MILLIONS EVERY YEAR to fund costly, duplicative bureaucracy and resolve legal questions caused by sponsor's failure to qualify initiative for 2012, as intended.
  • HIDDEN AGENDA — COSTLY NEW LAWSUITS. The sponsors made $11 million off legal fees under their last sponsored Proposition; now they're back to make millions more off the costly new health care lawsuits Prop. 45 allows.
  • Exempts big corporations.

Join doctors, nurses, patients, clinics and small businesses: VOTE NO on 45.

Gail Nickerson, President, California Association of Rural Health Clinics
Robert A. Moss, MD, President, Medical Oncology Association of Southern California
Kim Stone, President, Civil Justice Association of California

Arguments printed on this page are the opinions of the authors and have not been checked for accuracy by any official agency.

Argument Against Proposition 45

We all want to improve our health care system, but Prop. 45 isn't the reform we need.

Instead, Prop. 45 is a flawed, costly and deceptive initiative drafted to benefit its sponsors and special interest backers — while patients, consumers and taxpayers face higher rates, more costly bureaucracy and new barriers to health care.

Prop. 45 makes things worse, not better. That's why California doctors, nurses, patients, clinics, hospitals, taxpayers and small businesses all oppose Prop. 45.

GIVES ONE POLITICIAN TOO MUCH POWER — Proposed Section 1861.17(g)(2)

Prop. 45 gives sweeping control over health care coverage to one elected politician — the insurance commissioner — who can take campaign contributions from trial lawyers, insurance companies and other powerful special interests.

Under Prop. 45, this single politician could CONTROL WHAT BENEFITS AND TREATMENT OPTIONS YOUR INSURANCE COVERS — with virtually no checks and balances to ensure decisions are made to benefit patients and consumers instead of special interests in Sacramento.

"Prop. 45 gives one politician too much power over health care. Treatment decisions should be made by doctors and patients, not someone with a political agenda." — Dr. Jeanne Conry, MD, OB/GYN — Immediate Past President, American College of Obstetrics and Gynecology, District IX


Prop. 45 creates even more expensive state bureaucracy, duplicating two other bureaucracies that oversee health insurance rates, causing costly confusion with other regulations and adding more red tape to the health care system.

The non-partisan Legislative Analyst's Office projects the measure could INCREASE STATE ADMINISTRATIVE COSTS TENS OF MILLIONS OF DOLLARS PER YEAR — costs ultimately paid by consumers.

We shouldn't create a costly new, duplicative state bureaucracy when we can't adequately fund our schools, children's health care programs, or other priorities.



California just established a new independent commission

responsible for negotiating health plan rates on behalf of consumers and rejecting health plans if they're too expensive.

This independent commission is working successfully to control costs and expand coverage. We shouldn't allow a politician who can take campaign contributions from special interests to interfere with the commission's work.

EXEMPTS BIG CORPORATIONS — Proposed Section 1861.17(g)(3)

Prop. 45 exempts large corporations, even as it burdens small businesses with costly new regulations and bureaucracy. If we're going to reform health care, it should apply to everyone, not just small businesses and individuals.


Prop. 45's sponsors are lawyers who made millions profiteering off legal challenges allowed by the last proposition they sponsored, according to the San Diego Union-Tribune. They've hidden the same provision in Prop. 45, allowing them to charge up to $675/hour and make millions more off costly health care lawsuits.

The sponsors will get rich — consumers will pay.

Our health care system is too complex to make major changes through a proposition pushed by one special interest. If we're going to make changes, patients, doctors and hospitals should all be part of the solution.

Vote NO on Prop. 45.

Monica Weisbrich, R.N., President, American Nurses Association of California
Dr. José Arévalo, M.D., Chair, Latino Physicians of California
Allan Zaremberg, President, California Chamber of Commerce

Arguments printed on this page are the opinions of the authors and have not been checked for accuracy by any official agency.

Rebuttal to Argument Against Proposition 45

Californians are being overcharged by the health insurance industry. Proposition 45 will protect consumers and help stop the insurance industry's price gouging. It applies California's existing auto insurance protections, which have saved consumers billions, to health insurance.

Five health insurance companies that control 88% of California's insurance market have raised $25,300,000 against Prop. 45:

Blue Cross and parent company Wellpoint, Kaiser, Blue Shield, Health Net and United Healthcare. They want to keep charging you as much as possible without accountability, transparency or disclosure.

When did health insurance companies ever spend $25 million to save you money on your health insurance or to make your healthcare better?

Here are the facts:

  • Prop. 45 will not limit your benefits or treatment options, only how much you pay for health insurance. That's why the California Nurses Association, representing 85,000 Registered Nurses, supports Prop. 45.
  • There is no "commission" in California, or federally, that has the power to stop unreasonable health insurance rates. That's why Prop. 45 authorizes our elected insurance commissioner to reject excessive rate hikes. No insurance commissioner has accepted campaign contributions from insurance companies since 2000. No wonder health insurers are worried!
  • Prop. 45 won't create a new bureaucracy. It requires health insurance companies to pay for its implementation and obey the same rules, from voter-approved Prop. 103, that apply to other insurance companies. The insurance companies fear these rules and the consumer challenges to excessive rates that have cancelled billions in overcharges by auto, home and business insurers.

Dr. Paul Song, Co-Chair, Campaign For A Healthy California
Henry L. "Hank" Lacayo, State President, Congress of California Seniors
Harvey Rosenfield, Author of 1988 insurance reform Proposition 103

Arguments printed on this page are the opinions of the authors and have not been checked for accuracy by any official agency.

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