Previous research has shown that people in states with formularies that limit access to new drugs are more likely to die sooner than those that have access to innovation medications.. So read the following article with that in mind..
Will States’ Prescription Drug Essential Health Benefits Be Essentially the Same?
December 14, 2012 By Jenny M. Burke
A new study indicates that basic prescription drug coverage could vary dramatically from state to state as requirements under the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) are implemented. Under the new regulations, states have the ability to set minimum mandatory benefits for private health plans that will be offered beginning in January, 2014.
In a study released last week, the market analysis firm Avalere Health found that some states will require coverage of virtually all FDA-approved drugs, while others will only require coverage of about half of medications. Connecticut,Virginia and Arizona will be among the states with the most generous coverage, while California, Minnesota and North Carolina will be among states with the most limited coverage. Consumers in all states will have access to essential medications, but some will have fewer choices than others.
CMS recently released a proposed rule covering the requirements for the essential health benefits under section 1302 of PPACA, including the prescription drug and other benefits, the determination of the actuarial value of the health benefits, and recognition of accreditation agencies that will be responsible for determining whether health plans are qualified. The proposed requirements would apply to non-grandfathered health insurance plans offered in the individual and small group markets beginning January 1, 2014, whether or not they are offered on the health insurance exchange, but not to self-insured plans.
