Under ACA Section 1557, what can health plans charge based on an individual's age?

The Affordable Care Act (ACA) Section 1557 prohibits discrimination in healthcare programs and activities and extends protections for various groups, including based on age. However, when it comes to premium pricing, the ACA does allow for certain variations based on age, reflecting the understanding that health risks typically increase with age. This means that health plans can charge higher premiums for older individuals compared to younger ones, up to a specified ratio.

This provision is established to ensure that the premium structure reflects the increased healthcare costs commonly associated with aging. While the ACA implements measures to prevent excessive discrimination based on age, it does permit health plans to level premiums based on age as long as they adhere to the defined limits set forth by the ACA, which is typically a three-to-one ratio for older versus younger individuals. Hence, premium rates can differ in accordance with an individual’s age, justifying the selection of this answer.