The fight started back in March when Anthem, the California arm of Blue Cross insurance plans, proposed a premium increase that could be as high as 39%, just as the health care reform debate was heating up in Congress. After a review by the state Insurance Department and some retreating by Anthem, approval was given late yesterday to raise rates by an average of 14%, and as high as 20%, for nearly 800,000 individual California policyholders. As long as insurance companies spend at least 70% of their premiums on medical care there isn’t much that regulators could do to block Anthem’s rate increases, although changes should be coming. State lawmakers are considering legislation that would require insurers to get approval from the Insurance Department before raising premiums and the Obama Administration is looking at ways to give greater power to state insurance commissioners to regulate companies like Anthem. But it won’t come soon enough for hundreds of thousands of Anthem clients in California who will soon have to pay more for their healthcare.