[rdl]

(EDIT: WOW. It appears New York State, since 1992(!!!), has not allowed age rating. Unlike the other states.)

ACA plans are "age rated" (although only 3:1 from 26 to 64, unlike the true actuarial rate which is probably 6:1). It's not "discrimination" under the law. This effectively means young people subsidize old people. (a flat rate without age would be even more extreme, which would make plans essentially irrational for healthy <40 year olds)

NYS or NYC might be different; I know NY had some weird pre-ACA rules.

You used to be able to use gender (which was pretty universal; males were about 20-30% less than females even for plans which excluded childbirth); you can still use smoking. You can do community rating under certain terms too, although it's fairly restricted, and generally just means some insurers don't issue in some parts of states.

IIRC health history was used mainly as buckets; the "best" individual plans required an essentially clean health history, or would exclude pre-existing conditions entirely. Various legal hacks over the past ~10y created various forms of guaranteed issue.

http://ahip.org/Issues/Age-Rating.aspx has some info.