Which of these is NOT a factor relevant to the determination of higher premiums under ACA Section 1557?

The correct choice relates to the specific protections established under the Affordable Care Act (ACA), particularly in Section 1557, which prohibits discrimination in health programs and activities based on several factors. While health status, age, and disability are all elements that can influence insurance premium calculations and are subject to regulations within the ACA, marital status does not directly affect the determination of premium rates under these specific guidelines.

Under ACA regulations, it is mandated that premium pricing should not discriminate against individuals due to their health status, age, or disability—these factors are relevant and can potentially raise premiums based on risk assessment. However, marital status is considered a secondary demographic that does not factor into the premium determination directly according to the protections outlined in Section 1557. Therefore, recognizing this distinction helps clarify why marital status is not a relevant factor in the context of establishing higher premiums under the ACA.