Analysis finds big state-by-state swings in prescription coverage

President Obama's signature healthcare law requires insurance plans to cover a range of prescription drugs, but the number of drugs covered will vary widely from state to state, according to a new analysis from Avalere Health.

The Affordable Care Act requires plans to cover a set of "essential health benefits," including prescription drugs. To prevent benefit mandates from driving up premiums, the Health and Human Services Department has said it will let states fill in most of the details about their essential-benefits packages.

Each state will pick a "benchmark" plan comparable to either Medicaid or an employer-based policy that already exists in that state. According to Avalere's latest analysis, coverage for prescription drugs will vary from state to state.

Based on its analysis of state benchmark plans, Avalere said some states cover as little as 45 percent of available drugs, while others cover more than 99 percent.

"This means that ... linking drug coverage to the benchmark formulary will result in drastically different coverage requirements state-to-state," Avalere said.

Especially generous states include Virginia, Arizona, New Hampshire and Connecticut, as well as several rural states.

Some highly populated states offer comparatively skimpy drug coverage. The least generous category in Avalere's analysis — states whose benchmark plans cover 45 percent to 76 percent of drugs — includes California, Maryland, Michigan, Minnesota, North Carolina and Wisconsin.

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