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

Under the ACA, health insurers in the individual and group markets:

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

Why A is correct

The ACA's guaranteed issue requirement compels insurers in the individual and group markets to accept every applicant regardless of health status, and prohibits pre-existing condition exclusions for both adults and children. Rating may vary only by limited factors such as age, tobacco use, and geographic area, not by health. These protections are among the most tested ACA provisions in the A&H objectives.

Why the other options are wrong

  • B) Denying applicants based on illness history violates the ACA's guaranteed issue requirement; applicants cannot be turned away for health.
  • C) Health status is a prohibited rating factor under the ACA; premiums may not vary based on medical history.
  • D) Children with congenital conditions are expressly protected; the ACA bans pre-existing exclusions for children.

Memory hook

Guaranteed issue = no one is turned away for being sick. Pre-existing exclusions are history.

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