Your Approval for Health Insurance Is Guaranteed Definition:

Guaranteed Issue
A requirement that health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Except in some states, guaranteed issue doesn’t limit how much you can be charged if you enroll.

The Guaranteed Issue

If you sign up for health insurance today, the insurance company can’t deny you for a pre-existing medical condition, but it’s not always been this way. Let’s take a look back for a minute. Laws have varied by state, but in most states an individual who had a pre-existing condition, or came down with a condition such as cancer could not get an individual or family health insurance plan.

Some insurance companies had a list of over 400 different medical conditions that could trigger a denial. People were turned away, or if they had a condition that was lower risk, some were offered coverage for a higher premium.

For millions of Americans this was a major hardship. That all changed with the passing of the Patent Protection and Affordable Care Act (PPACA) on March 23, 2010. It became a federal law that health insurance policies must be sold on a guaranteed issue regardless of health status. This was an amazing step forward in moving the county toward a better system of healthcare, where all could be insured.

Key Dates

  • March 23, 2010 – Patent Protection and Affordable Care Act (PPCA) signed into law
  • September 23, 2010 – All children under 19 could receive coverage guaranteed issue
  • January 1, 2014 – All applicants for individual, family and group health plans are guaranteed issue


There are a few health plans that are not required to follow the new rules of guaranteed issue.

  • Supplemental insurance (some types). An example of this would be Short Term Insurance. Plans such as these do not have to meet the requirements for Obamacare California, so they are exempt from guaranteed issue.
  • Grandfathered Plans that were in existence before the new law was passed on March 23, 2010.



Not sure how Obamacare affects your health care plans in California? Learn how the ACA works in California, including benefits, costs and enrollment.

Covered California is the Golden State’s official health exchange marketplace where individuals, families and small businesses can find high-quality, low-cost California government health insurance.

Learn about Obamacare income guidelines in California using our income limits chart, and see if you’re eligible for government assistance.

Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.