Under the Affordable Care Act (ACA), when can insurers deny health coverage for pre-existing conditions?

The Affordable Care Act (ACA) established significant protections for individuals seeking health coverage, particularly regarding pre-existing conditions. Under the ACA, insurers are prohibited from denying coverage or charging higher premiums based on pre-existing conditions for most plans. However, there are exceptions for certain types of plans, notably Grandfathered Plans.

A Grandfathered Plan refers to a health insurance plan that existed in some form before the ACA was enacted on March 23, 2010, and has not substantially changed. Because of this status, these plans may not need to comply with the ACA's requirements regarding pre-existing conditions and may choose to deny coverage based on those health issues.

This distinction is crucial in understanding how the ACA interacts with existing health plans. While the ACA has increased consumer protections significantly, Grandfathered Plans are an exception where insurers may still apply pre-existing condition exclusions, making this the correct contextual response to the question.