>>I had heard numbers more like 20% for people who had plans that had be upgraded (or downgraded, depending on your point of view.)

Maybe... but what's the denominator? 20% can be less than 5% depending on the ratio of the cohort to the whole.

In the interests of balance: not widely reported yet, but medication costs are indeed all over the place from plan to plan and it's not easy for physicians or patients to be sure what drugs are or are not covered. Behind the scenes it appears that a lot of drugs are ending up in the highest-priced Tier 4 which can be a surprise to patients. E.g. diabetes drugs, which actually is quite tiresome: if you want to reduce your healthcare costs, preventing diabetic morbidity makes a massive difference and you need to reduce barriers. One diabetic coma blows the cost of a year's meds out of the window. Which is one of the usual international trends that is yet to manifest fully in the new system: a pinch of prevention is worth a pound of cure. You already know this in the US where you rate very highly in preventive stats- and insurers need to get with the program now that they no longer can exclude expensive pre-existing illness or resile if a policyholder has the temerity to become seriously unwell. It will come- because it's profitable for everybody to prevent expensive episodes of care. Meantime some patients are disadvantaged because their pharmacy bill is higher than they'd hoped.