Georgia Navigator Practice Exam

Which factor is not allowed to be used by insurers for underwriting health insurance according to the ACA?

1. Age

2. Gender

3. Behavioral history

4. Geographical location

The correct answer is: Gender

The Affordable Care Act (ACA) established important consumer protections, one of which is the limitation on the factors that insurers can use when underwriting health insurance. Specifically, the ACA prohibits insurers from discriminating against individuals based on certain characteristics. One of the significant protections in the law is that gender cannot be used as a basis for determining premiums or eligibility for health insurance. This means that insurers are not allowed to charge different rates based on whether an individual is male or female. On the other hand, age can still be used, with certain limitations, as insurers are allowed to vary premiums based on age groups; however, they cannot charge older individuals exponentially more than younger individuals. Behavioral history and geographical location can also be used by insurers to assess risk and set premiums, reflecting the differences in health outcomes or healthcare costs associated with these factors. Therefore, gender is the factor that is not permitted under the ACA for underwriting health insurance.