WHAT'S AHEAD: Some states are allowing insurers to charge patients a hefty share of the cost for expensive medications used to treat cancer, multiple sclerosis, rheumatoid arthritis and other life-altering chronic diseases in order to keep premiums low.

STICKER SHOCK: The result is that a widely used cancer drug could end up costing New Yorkers a monthly copay of $70, while Californians would pay more than $2,000 for a month's supply.

TWO APPROACHES: Critics fear most states will follow California's lead, and that could defeat the purpose of President Obama's health care law, because some of the sickest patients may be unable to afford their prescriptions.

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