Under community rating, a health insurer would charge all people in a community who are covered under the same type of health insurance policy the same premium without regard to age, gender, health status, occupation or other factors. Before the ACA went into effect in 2014, insurers could charge each consumer based on what’s called experience rating, meaning they could charge higher rates for women, the elderly, those with poor health status or any pre-existing condition. Also, they could choose not to cover some consumers. Under the ACA, community rating was limited so that older consumers could be charged three times as much as younger people (in some states it had been much higher) and there is no extra charge for women of child-bearing years or people who have been sick. Smokers can be charged more and participation in wellness programs can affect premiums.
