As a registered nurse, I’ve watched health insurance premiums jump while benefits and doctor networks shrink. I’ve watched patients pay thousands out of pocket before insurance pays for anything.

We all have to buy health insurance under federal law. But there is no guarantee that it will be affordable. Proposition 45 provides that guarantee. It gives California the same power 35 other states already have to reject excessive rates.

Prop. 45 makes the elected Insurance Commissioner, who answers to voters, the umpire over whether rate hikes are excessive – without affecting benefits or treatments. It requires health insurance companies to open their books and justify rate hikes to the elected insurance commissioner before raising rates on 6 million individuals and small businesses that have to buy their own insurance. Prop. 45 holds health insurance companies accountable by requiring health insurance company CEOs to request permission for rate hikes under penalty of perjury.

Health insurance companies fear this rate relief, so they have poured $37.5 million into a deceptive campaign that wrongly claims Prop. 45 hurts the state’s bulk purchasing pool, Covered California. That’s because they know Prop. 45 will stop rip-offs and save Californians tens of billions of dollars.

Prop. 45 simply extends to health insurance rates the successful regulation for auto and home insurance that voters enacted in 1988 when they created the office of elected insurance commissioner, accountable to the people for the rates they pay. California drivers now pay less in real dollars for insurance than they did 25 years ago – the only state with such success.

Another key to auto insurance reform’s success was the same consumer participation system that applies to electricity rates. Consumers can challenge unreasonable auto, home and business insurance rate hikes. Since 2012, over $3 billion in proposed rate hikes have been stopped by consumer group challenges.

Rate relief has proved an undeniable consumer triumph for drivers. Those required to buy health insurance under federal law deserve the same protection. No one should have to pay unaffordable premiums that cover very little. Health insurance companies want to keep charging you unreasonable prices for health insurance. Don’t let them.

Margie Keenan, R.N., of Long Beach, serves on the executive board of the California Nurses Association, which supports Prop 45.