Which of the following was not an element of the Patient Protection and Affordable Care Act (PPACA)? Multiple Choice bled Insurance companies can no longer deny coverage to anyone on the basis of a preexisting condition To contain costs, insurance companies may impose annual or lifetime expenditure caps on those that they insure a All time with 50 or more employees are required to purchase insurance for their workers or pay a fine Individuals who were not covered by the government or employer provided insurance were required to purchase health insurance for themselves and their dependents