The ACA 'guaranteed issue' requirement means that health insurers must:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Guaranteed issue is the ACA requirement that health insurers in the individual and small-group markets accept every applicant who applies and renew every policyholder, regardless of health status, age-related conditions, or claims history. Insurers may not medically underwrite individual and small-group applicants to decline or price coverage on the basis of health. Premiums may still vary by limited rating factors such as age, tobacco use, family size, and geographic area, but coverage itself cannot be denied on health grounds. The prohibition on health-status rating means an applicant with a serious illness pays the same base rate as a healthy applicant of the same age in the same area, with only age, tobacco use, family size, and geography adjusting the premium.
Why the other options are wrong
- B) Guaranteed issue guarantees acceptance, not price; premiums legitimately vary by age, tobacco use, area, and plan design.
- C) Premiums are set annually and may change; guaranteed issue does not lock premium levels for life.
- D) Guaranteed issue applies to medical expense coverage in the individual and small-group markets, not to disability policies.
Memory hook
Guaranteed issue = the 'no bouncer' rule. Health history cannot stop you at the door, and renewal is assured.