Health history and gender off-limits, California insurers may turn to geography to set premiums

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People march in favor of the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court on March 26, 2012 in Washington, DC.

Geography is going to play a larger role in how much some Californians will pay for insurance under the federal health overhaul.

Insurers are facing new rules and restrictions on how they set premiums under the Affordable Care Act. They no longer can factor in gender or a person's health, for example, leaving geography as one of the few ways insurers can adjust premiums.

California's health exchange is moving ahead with 19 geographic rating regions. It will need approval from the federal government, which wants no more than seven in each state.

The regional rating system will affect individuals and small businesses buying insurance through the new marketplace. It will be one of the issues California lawmakers will tackle in a special session starting next week.

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