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Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 2/5

Under the ACA's guaranteed issue requirement, health insurers must:

Select an option to reveal the answer and the full 3-part explanation — free, no signup.

Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

Guaranteed issue requires insurers in the individual and small group markets to accept every applicant who meets the eligibility requirements, without regard to health status, medical history, or pre-existing conditions. Premiums may vary only by permissible factors such as age, tobacco use, geography, and family size, never by a person's health. This rule, together with the ban on pre-existing condition exclusions, is the core ACA protection against medical underwriting.

Why the other options are wrong

  • B) Denying coverage based on pre-existing conditions is exactly what guaranteed issue prohibits.
  • C) Health-status rating is banned; premiums cannot reflect an applicant's medical history.
  • D) The individual market is open to all applicants, not restricted to employees of large groups.

Memory hook

Guaranteed issue = no health-status questions gate the door. Premium factors are age, tobacco, area, family size.

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