Formularies vary from health insurance provider to health insurance provider, and from one health care insurance plan to another offered by the same health insurance provider. All formularies include certain basic medications, but formularies can vary widely, especially when it comes to new medications.
Not only were Representative Miller’s examples false, but his conclusion was wildly off the mark. Insurance companies are not evil entities, groping around for ways to deny coverage. As I have explained in this space before, they are functioning exactly as any insurer does, using actuarial science to maintain the balance between premiums and losses. Since they already are forced by law to accept people with costly preexisting conditions in their group policies, they need to draw the line at what they can cover without going out of business.