More of your ACA premiums for 2021

A lot more.

Earlier this week, I posted the first batch of what readers sent me about what they’re paying for health insurance next year. We heard from a nanny who’s paying $732 a month so that she can see a therapist for the first time since college, an asthmatic who’s grateful to ‘only’ pay $65 a month for his inhaler, and a woman who needs coverage for exactly ten days (at a cost of $438.14).

Today’s newsletter contains a lot more of your premiums, deductibles, and healthcare nightmares. We have many laid-off workers and several people struggling with mental health issues. We have more confusion and exhaustion about subsidies, and many, many more stories of being unable to get care because of cost.

It’s a long post, but I hope you’ll stick around to the end. This newsletter exists to share stories about healthcare. It’s important to me that I try to post as much as possible from what you share with me, on this topic and everything else I’ll write about. It means so much to me when people reach out to talk and agree to reveal these often-painful details from their lives; my end of the bargain is to respect the value of their individual stories, and to faithfully convey what they’ve told me. I won’t always be able to write about everyone, or reply to every email, but I will do the best I can.

In just a couple weeks, I’ll start publishing Sick Note full-time: At least one interview a week about healthcare, plus weekly roundups of healthcare news. I’d love to hear from you about what else you’d like to see in this newsletter, too. If you like it so far, I think you’ll like what’s coming next month. Please subscribe if you can.

TW: Depression and thoughts of suicide.

Waiting on Appeal

Costs: $381/month
State: Michigan

I was notified that I do not qualify for a premium tax credit. Although I estimated mine at $30K/year or $2.5K/month, the site claimed it would be $53.4K/year. As a result, my premium is $381/month. [...] I appealed and actually received a phone call yesterday from someone working on it!

Without the ACA I would not have healthcare coverage right now. My employer cut my hours by half in March, laid me off in May, and was generous enough to keep me on its plan until November. But remote jobs with medical benefits are scarce on the ground right now, and as I live with an immunocompromised person I'm not comfortable working outside the house. I don't have any pre-existing conditions except depression; when I last had private insurance the response was to then exclude coverage of that from my plan.

Obamacare has been a godsend for thousands of people, and was also kneecapped from its inception. Despite my reduced income, I would happily pay more in taxes to know that my neighbors and the most vulnerable had healthcare. 

The Artist

Cost: $0, reduced from $103.84/month
State: Texas
Job: Laid-off artist 

My situation is a little weird, because I live in Austin, TX and here there is a program called HAAM—Health Alliance for Austin Musicians. If you qualify, and if you sign up for a Marketplace plan with one of their employees, and if they still have the funds, they cover the cost of your premium payment. So, I'm actually paying $0 for this plan (which is honestly absurd, because it's the nicest plan I've ever had since I've started handling my own health insurance a few years ago). 

Even if I didn't work with HAAM, I probably would've gotten this plan because at this point, given the possibility of getting sick, and being in my mid 20's where I feel like my mental health will make itself more apparent than it ever has, paying $100 for this type of insurance seems reasonable. I want to do all the run of the mill health care things, get a physical, get tested for behavior I've been self-diagnosing for a few years (ADHD, OCD, anxiety, depression, etc). 

The whole process/system makes me mad! In Texas it's especially bad because the qualifications for Medicaid are... nonsensical? They make it nearly impossible to acquire premium assistance unless you are making enough money, but to my understanding the whole point is to be offering low cost health insurance to people who aren't making enough money.

No Premium, But There’s A Catch

Cost: $0/month, $7,200 deductible
State: Pennsylvania

I am a laid-off service industry worker collecting partial unemployment and putting in 1-2 days a week at a doggy daycare while I wait for things to either a) go back to normal b) before I start a Master's next Fall. Actually, I am also scrambling to find a second job as the prospect of a new stimulus bill dwindles. It's surreal to be looking for work at places that in normal times I probably would have turned my nose up at in normal times. It's been humbling, to say the least.

On the plus side my premium is going from forty-six dollars to zero dollars next year. I'm not really sure I understand why, but suffice it to say, the income-based tax credit I earned while applying for healthcare on the U.S. marketplace carried over along with my current plan and somehow zeroed out what I would have been paying monthly, though it did not this prior year. I'm not going to look a gift horse in the mouth, but it's not like I had the best healthcare to begin with anyway.

I only ever really used it for medication and under my current plan it's 20 dollars per refill for generic prescriptions. My deductible is an astronomical 7200 so I never really used it for anything besides the aforementioned and annual check-ups anyway. I do have dental, which I had for the first time ever this past year, but never used because pandemic.

[...]

Currently, I have more money saved up than I have ever had in my entire life because of the CARES Act enhanced unemployment. It sucks that if I don't find a new source of income soon, I have to see my first savings ever get bled out slowly to pay bills. Especially since most of my work experience is in the service industry. Either put myself on the line to get paid, if I can even find a job, or lose all this money that is providing me a sense of stability and confidence I had never felt prior to the pandemic. There is a certain level of guilt about being one of the people actually flourishing during all of this, but I guess even that was to be short-lived. It's not like I'm rolling in cash, it's just more than I am used to having before. I don't know. I just want to not feel like a nervous wreck thinking about the future for once in my life.

The Actor

Cost: $155.20/month, $1,200 deductible 
State: California 

I've been buying on Covered CA for the last two years because I'm an actor who doesn't make enough to qualify for SAG-AFTRA insurance and my other job as a brand ambassador for events is considered self-employment. As you can imagine, the events industry is nonexistent this year, and while some stuff is filming, there's hardly a ton of work at the moment. After years of flirting with it, I finally succumbed to pretty severe clinical depression last fall, and initially sought help through my insurance (Kaiser HMO), which, while "affordable" was completely inadequate. I found an excellent therapist out of network who in turn referred me to an excellent psychiatrist, also out of network, and asked my family to help pay.

Knowing that I had expensive mental health needs, I looked at plans for next year that would cover some of those costs, specifically a PPO with a reasonable deductible. I thought I had found one in the Blue CA Gold PPO. For a higher monthly premium, I thought I could get 50% of my therapy reimbursed *without* having to meet a deductible (see screenshot). I got connected with an adviser to help me navigate the marketplace who told me that that was an error—I'd still have to meet the 5,000 deductible and here's the kicker: they would reimburse me 50% of what Blue CA deems those services to be worth, not what they actually cost. Which meant I'd be getting $15-$45 back on my $150 session fee. I didn't see that fine print anywhere on the info provided by Covered CA. The increased premiums were definitely not worth it for such minimal benefits.

So next year I'm back to the Kaiser HMO and paying out of pocket for therapy and psych appointments because that's the cheapest option. Hoping I can get on the SAG plan or some better employer insurance this year because I can't keep asking for help from my family. Not the most dramatic story, and I'm grateful to have help, but I just get so mad when I think of people in distress trying to navigate this system.

The Procrastinator

Costs: $457.38/month, $4,700 deductible
State: New York
Job: Laid-off audio engineer

I've procrastinated pulling the trigger for months now. I'll periodically look at the plans on [the NY exchange], then my eyes will glaze over and I have to close the tab and lie down. This can't be the entire range of options, I think to myself, I must be misunderstanding.

Now there's a week left and it's time to suck it up. What I'll be sucking up is that I'm paying $5400 a year for... well, nothing, other than the peace of mind that I won't go broke if I get hit by a car. Hopefully I won't come close to reaching the $4700 deductible, but of course I'll be paying out of pocket for anything I might need throughout the year. This plan (bronze-level) made more sense to me than paying ~$300 more per month for a $3000 deductible. The one thing I actually "like" about the plan is that I'm able to use out-of-network providers while reaching the deductible. So there's a certain perverse elegance there.

I'm at peace with it, having realized this is literally just insurance, not a health care plan in the traditional understanding. But it makes me nauseous and I hate it.

Bad Timing

Costs: $457.38/month, $4,425 deductible
State: NY
Job: Lab tech

-Chose plan because it has the cheapest premium of any individual plan (Fidelis ‘bronze’ level) offered by NYS marketplace. It offers no routine adult vision, adult dental or foot care

-Bought ACA plan in 2019 because workplace plan had too many doctors dropping out

-Treated this year for foot pain including a dislocated toe from repetitive stress (I don’t know how, either; normal weight, no injuries) and paid out of pocket almost entirely for office visits, fitting and orthotics to manage pain (x ray and rx anti-inflammatories partially covered), $1250.

-Very unlucky to be diagnosed more recently with degenerative disc disease in neck vertebrae. I still haven’t met the deductible with MRI and 5 visits to the orthopedist for epidurals/nerve blockers so I can begin physical therapy. Deductible and out of pocket max will roll over in 3 weeks.

Exhausted By Friction

Costs: $419.97/month for two people, $1,000 deductible
State: New Mexico
Job: Freelance journalist

My spouse has a chronic illness that requires specific medications and sometimes physical therapy, and so we go into every ACA plan with the intent of making sure it can cover all that, though it is often hard to know when picking a plan if it will work as promised. We live in New Mexico and this is the second ACA plan we've had to pick this year. I had a full-time job with benefits at the start of the pandemic, but I was laid off from that job and June was the last month of coverage I had. The plan we picked was fine but we received notice this fall that it was being discontinued, so we did our best to figure out the plan closest to it. This is what we settled on.

I've never been great at the "estimating income" part of it, and I specifically remember having to pay back a subsidy in my 2018 taxes because I got a full-time benefits job part way through that year. What was most different this year was helping my mom figure out her ACA plan, because COBRA insurance through my dad's retired job is expiring, and while my dad is on Medicare, my mom still has a few years to go. The way prices can jump around based on changes in estimates felt, in her words, like refreshing prices on plane tickets and seeing them go up once they notice you're interested in a specific flight. I'm reasonably sure that the ACA marketplace isn't that specifically capricious, but it's not a great feeling!

As for the plan itself: I'm hoping it works? I have no experience of buying insurance pre-ACA, so I can't speak to it relative to that. But I can say that every time I have to jump through these hurdles, and it's been at least 6 or 7 times I think, I just end up exhausted about the whole process. It's a ton of friction, I risk penalty for not knowing the future and for not collecting data better than the government, and I get to find out every single time anew if I can see any of the same doctors that I was seeing previously.

Waiting for Disability

Costs: $403.98, $5,500 deductible
State: Washington

I had a neck surgery in Oct 2016, Nov 2017 (to fix the first one – put in an artificial disc that was too big the first time so they took it out and fused it) and then a back surgery in April 2019. I kept going back to work after every surgery – I needed my health insurance. I am also a migraineur. What initially sent me to the doctor was a combination of extreme fatigue and numbness in my arms. The first doctor thought I was depressed despite me telling her I did not feel depressed and put me on Prozac. I insisted that it was something neurological and she completely ignored my reports on numb arms and legs.

I went to a different doctor who then referred me to a neurologist when they found the disc bulge in my neck that was narrowing my spinal cord. I was referred to a surgeon and had that first surgery a month later.

More specialists, more appointments – my life became all about doctors and bills. We’ve probably spent $35k out of pocket even with the “good” employer-provided insurance in four years. In September 2019 I finally had to admit I couldn’t work anymore. 

[...]

I filed for SSDI (Social Security Disability Insurance) in October 2019. I just got a letter (after several denials and appeals) that I will get a 75 day heads up on a hearing, which can take months to schedule, and that it takes 3 months after the hearing to get a response.

[...]

I hope that I can get my SSDI approved so that I can be on Medicare and finally be able to have the procedures and specialists that I have had to put off get me back into working shape. My best guess is that it will have been two years since my application if and when I am approved. COVID has exposed many of the gaps in our system – anyone who has dealt with needing SSDI could tell you that all of these system gaps have existed within the SSDI realm for years. If I could have been approved for Medicare at the beginning – never mind the SSDI payments that I have paid into since 1986 – it’s possible I could have been back to work by the time they approve it. 

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The Small Business Employee

Costs: $396.69/month, $5450 deductible 
State: Indiana

I'm 36 and single. No dependents. I have never had insurance through an employer. I'm currently an office manager for a family law attorney. My boss is over 65 and on Medicare, and I am literally the only other employee. Not really an affordable option for her to offer me health insurance.

I had some health issues in 2019, so I decided to splurge on a "gold" plan for 2020, knowing that I would need a shitload of tests and scopes this year that I didn't end up getting anyway thanks to the pandemic. It was $374.48/mo (after the subsidy) and a deductible of only $1,250. The lowest deductible I've ever had. Unfortunately, it was going to be way too much money to keep a gold plan for next year, over $500/mo, so I picked a silver plan with the closest premium to what I was already paying. My plan for 2021 is now $396.69/mo (after the subsidy), but my deductible is now going to be $5,450. So in one year, my premium is going up $22.21, but my deductible is going up over $4,000. So no, I'm not pleased with the ACA. All the tests and procedures that I put off because of the pandemic, I'm just going to have to put off due to the expense in 2021. I'm sure other people will have much worse horror stories, but it's still infuriating that this is what Democrats are trying to keep in place.

The Small Business Owner 

We're a small construction company and can only afford to cover the office staff, which is bullshit, but we tried briefly to cover field installers and it wasn't even something they really wanted or used, so we just try to pay a higher hourly rate. Having to make this shitty decision for our employees is one of the main reasons I support M4A. None of my competitors even have employees, they all hire independent contractors so the fact that most of our guys get over $20/hr is pretty good for the industry. 

Anyway, I'm in charge of picking the plan. We only ever switched once, when the ACA passed and we could actually get a group plan. Before it was all individual plans and they were dogshit by comparison. After the first year of ACA our premiums actually went down 18%. I think because of the profit limitations in the ACA. Since then it’s been 3-5% increases. This is for 2021 and the increase is 9%. Since it's a group plan, we have to get it through a broker. I shopped around and the two brokers I dealt with came up with the same plans, so I don't think it matters who you get it through. 

The Furloughed Cook

Costs: $99.06/month, $1,000 deductible
State: Hawaii

I had to buy insurance from the ACA for the first time this year. I ended up picking something that seemed similar to what I had had through my employer. I did try applying for medicaid, but apparently I earn too much money collecting unemployment. 

I'm a 32 year old woman and I was (am?) a pastry cook at a 5-star resort on the Big Island in Hawaii. [...] I guess my status is technically furloughed, because when (if?) tourism gets back to normal I will be brought back without having to go through a rehiring process.

I went with a "gold" Kaiser Permanente plan with a $1000 deductible. I had Kaiser through my employer and never had trouble with it so why not. With my tax credit it's $99 per month. There was the option of a bronze one for literally $2 per month with the tax credit, but of course the deductible was ridiculous. I can afford to eat the cost of $1000 in a year if I have to. This plan also has a $350 copay for emergency room care, as opposed to some others that had things like 20% coinsurance. I went with that because you never know, right? Kind of like how you described in your newsletter, I felt like I could sit here for hours and compare prices and coinsurances and stuff, or just say screw it and go with my gut. I was able to afford to throw in a $32 per month dental plan as well.

Overall the experience of buying insurance was fine. I think I got a good plan for an okay price. I just resent it because I know there are places where people don't have to do this. I have a college education and tax credits and deductibles barely make sense to me. I get annoyed trying to pick out name brand vs generic foods at the grocery store, I don't want to have to do that for something as important as health insurance. My sister had a bicycle accident on vacation in England last year and paid nothing to get stitches! And I have to line the pockets of Kaiser Permanente AND pay more taxes in 2022 if I go back to my job and my income goes up. 

The Risk Assessment  

Costs: $268.93/month, $6,100 deductible
State: Florida

I am 32 years old and I work as a freelance projectionist and tech manager for film festivals. For health insurance reasons, I list my income as 3,500 a month but due to the freelance nature of my job, there are certain months where I might make 12k a month and some months where I don't make anything. I get a tax credit of (lol) $72.00.

[...]

As you see, part of the reason I choose my insurance plan is so I can see my primary care doctor, who is affiliated with the University of Miami. I have been to the doctors a total number of zero times this year. I always hate the process of buying insurance but since I work in events, there is always a chance that a projector will fall on top of me. It would be dumb for me NOT to have insurance. But also paying $250+ a month for the pleasure that I would only be moderately financially ruined if I had to go to the ER isn't very comforting. 

Covered California, For Now 

Costs: $198.73/month, $3,700 deductible 
State: California

I do want to note that I will likely lose the tax subsidies in April, after my taxes are finalized.  Since I am self-employed, I won’t know my yearly income until then — so my eligibility right now is based on my 2019 income.  If I do, it will raise my monthly premiums to $326 — which, to be honest, I don’t think I’ll be able to afford and may need to drop coverage. :/ 

I live in Long Beach, CA and I’ve been self-employed since 2018.  I run a small online business - reselling clothing on platforms like eBay, Poshmark and others. I first tried to get coverage back when I left my job in 2018 (which I stayed in way too long because of health insurance) — but I was able to afford the premium but not the copays and prescriptions, which were crazy high.  This also weighs into the plan I choose — I tried to find an option that was A) in-network for my doctor, B) reasonable monthly premiums and C) reasonable RX and copays — even if it means having a much higher deductible.

The process of getting coverage through Covered CA was surprisingly easy — I was pretty impressed.  Renewing my coverage for 2021 was even easier — to the point where I had to keep checking to make sure it was done correctly, because it felt too easy.  It also helps that I am keeping my same plan as this year.  

As I need to go to the doctor monthly in order to have my prescription refilled — I am just happy to have insurance.  I worked super hard in 2019 with the sole focus of being able to afford my premiums and copays/RXs consistently each month.  The first time I was able to see my doctor and get back on my meds was like a mini-celebrations.  

The COBRA Conundrum

Costs: $271.16, $6,300 deductible 
State: California
Job: TV production coordinator

I moved from a big studio where I had a plan I really liked (a Kaiser HMO with no monthly premiums and a $100 deductible) to a smaller studio where I will eventually have health insurance but only after I have worked there for 3 months. I think the insurance at the new studio is Aetna and it has no premiums but a $6,000 deductible. 

This really stressed me out and made the consideration for changing jobs much more complicated, which is I guess the point for the big studio. And then for the small studio, I guess the point is that they don't have to provide health insurance for 3 months and it's their prerogative to do that. 

I decided to change jobs anyway and figure out the weird gap in my health insurance myself. I could either get COBRA coverage, which was $500/month for my old, previously free plan or go with Covered California. I have had Covered California before so I at least knew how to navigate it and was vaguely aware of the difference between co-pays and co-insurance and deductibles and out-of-pockets but then again I still don't really get it at all. 

I chose this bronze Kaiser Plan because at least it's the same insurance company that i had, although now it has a $6,300 deductible. It was also basically the best plan that I could get while still saving money from not doing COBRA. For now I can feel good about saving $750, although if I have to use the plan I might not actually be saving any money and could potentially be on the hook for thousands of dollars. So that's a fun gamble to make.

The Cancer Patient

Costs: $432.70/month
State: DC

This coming year will be my second one on the exchange, and just renewed with the same plans I had previously. I’m a program manager at a nonprofit that’s too small to offer a group plan. They offer a three hundred a month stipend for health insurance, which is how I can afford the plan I picked.

I originally picked it last year for a couple reasons. Mainly, I wanted one with a low deductible and that offered coverage out of state so in case I got in accident or something outside DC borders I could still be in network. I also looked at in network out of pocket caps and tried to pick one so that if I got sick in December and hit the maximum, then had to repay until I hit the maximum in January, that I could get by on savings/my current credit card limit. Out of network costs were a lost cause regardless. I think there was only like three or four plans that fit, and I have a grudge against Kaiser for absolutely no good reason, so ended up picking the slightly cheaper of the CareFirst plans.

Originally I was pretty frustrated by the experience, because the only good plans were so expensive and it was so hard to tell how much the copays etc. were for different services. I ended up getting diagnosed with cancer mid year though, which really changed my perspective on my plan, since I definitely wouldn't have gotten such good coverage through my employer. Seeing the before insurance price of the bills for surgeries/treatments etc. has been appalling, if not unsurprising, but the plan I’m on has made the costs relatively manageable. I would still much prefer to have Medicare for All, but as many failures as the ACA has, it gave me a lot more flexibility than I would have had otherwise and if my employer did offer the choice between the stipend and a group plan, I’d likely still choose to stay on the marketplace.

Lucky, But Not Thrilled

Costs: $121.58/month
State: Massachusetts

I believe I had ConnectorCare Type 2 a few years ago (it’s 3A now), with everything costing about $87ish monthly. That was too subsidized for my income, and received a smaller tax refund for a couple of years before I increased my monthly cost.

I work for a UPS Store and have been fortunate to be in a line of work that has not been negatively affected by the pandemic. Because UPS Store employees are employees of the small business franchisee and not of either the UPS Store corporate or UPS directly, I am not offered health insurance at my job. Approximately 2 years ago the plan I had previously through Health Connector, which I cannot remember the name of, stopped being available, so of the handful of options I had I chose Tufts, because they seemed less likely to close up, and their cost was similar to my old plan. I wasn't thrilled with the lack of options. I've been lucky to have most things covered and prices not be too high for what I've needed. 

The Escapism Plan

Costs: $121.58
State: Pennsylvania

With the tax credits as reported, my monthly will be about $150, for what looks like slightly better coverage than what I had in 2020. Plus $8 for Dental. I straight up don’t know if I had Dental Insurance last year. Delta Dental has not been very communicative but apparently they’re happy to take my pittance for a flimsy paper card. Moot point as I don’t anticipate seeing a dentist until vaccines are widely available, so I guess August 2021 if I’m pessimistic. I really like my dentist, actually. He’s extremely fast. In and out in 20 minutes.

That said, I’m not even going to get my money’s worth for that heavily discounted $150. I have untreated severe depression and anxiety, and at my lowest last year, when I finally ginned up the courage to call the primary care provider I have never seen, they told me there was a months long wait to be seen. Never mind needing a referral to a psychiatrist. This was all Pre-COVID, mind you. I stood down – didn’t press the issue. For $250, I can go get a medical marijuana card via telemedicine, tell them I have PTSD and can’t sleep, get approved instantly and be done with it. But if on some very black day I feel I want to open my veins and let the darkness take me, there doesn’t appear to be immediate recourse other than the ER. The only thing carrying me on right now is my parents – it would kill them if I checked out. I might be sad but I’m not in danger. So for now I just crack another beer, fire up the PS5 and escape into escapism. I consider this sub-optimal, but it could be worse I guess.

But yeah, barring some severe emergency like getting hit by a bus, I’m basically paying for nothing. It sucks ass.

Depressed by Insurance

Costs: $251.17/month, $125 deductible
State: Illinois

I lost my job in June, I worked as an elementary school technology teacher. Not explicitly due to covid, but I didn’t transition to teaching from home well, and I kind of suspect my principal just wanted me gone. Kind of a blessing in disguise, because of how shitty schools have handled things in the fall, I would have been teaching in person on August. Anyway, I am fortunate to be in a good financial position, so I've been able to stay unemployed. Started grad school too, mostly just so I can pretend to other people that I'm doing something. I live with/take care of my grandma, which is good because I don't pay rent, but bad because I get to perpetually still feel like a high schooler.

[...]

Overall, I have had to pay more attention to my insurance now than I ever did before. I remember when I switched off my moms plan at 26, to my work plan, my therapy appointments got cut from an hour, to 45 minutes. Just seems so arbitrary and cruel, everything so obfuscated so I could never possibly fight it. The more I think about health insurance, the more I hate it, the less I actually want to be treated (literally being treated for depression and suicidality).

Catastrophic Or Not?

Costs: $157.59/month (Catastrophic plan), $8,550 deductible
State: Hawaii

I'm a freelancer who recently relocated to Hawaii for my partner's job. In New Mexico, where I lived before, I recently got on an ACA plan for about $300 a month. Before that, I was covered under my parents' insurance, but lived in a different state and couldn't go to a doctor there since it was out of network.

I switched to a catastrophic plan when I moved for money reasons. I currently pay ~$150 for that (but can't really go to the doctor now either since the deductible is sky-high.) I'm thinking about switching to a ~$400/month plan in the new year so that I can actually go to the doctor and get random minor stuff checked out for the first time in... five-ish years? But I'm not sure if I can afford it (or if my income will remain stable enough that it would even be in the realm of possibility.) I'm also considering just sticking with the catastrophic plan until I can get on my partner's work plan after we get married.

There are a couple of plans in between the $150 and the $400 ones, but they have high enough deductibles that it would functionally prevent me from going to the doctor in the same way the catastrophic plan does. I'm entitled to a free "preventative care" visit under the catastrophic plan, but my understanding is that I can't, like, ask about the weird bump on my leg or why I'm tired all the time without incurring additional costs.

Basically, my current healthcare plan would keep my medical bills under ~10k if I were hit by a bus or something, but doesn't do much beyond that. That's not nothing, but definitely far from ideal!

(Sick Note: She stayed with the catastrophic plan.) 

The Subsidy Gamer

Costs: $582.82/month, $16,300 deductible
State: Illinois 

I'm married, and have an 18 year old.  This coverage is for us 3.  I retired from tech in 2019 - early.  We're very financially blessed.  None of us work.  I feel a little guilty using a subsidy, because I can "engineer" my yearly income to a level to qualify for it (too low, and they put me in Medicaid, and too high I don't get subsidies).

I got this same plan for 2020.  It's fine.  You get copays immediately without first hitting the deductible, and that has covered nearly all of our medical needs.   If disaster struck we could comfortably hit max out-of-pocket.

In general, I'm very happy with ACA.  I had great employer-provided coverage, and going into retirement health insurance was my wife's greatest concern.  The undeserved subsidies alleviate her concerns.  Would single payer be better?  Undoubtedly.  But aside from the insurance company having incompetent support staff, it's been good.

Filled with Dread

Costs: $221.75/month, $8550 deductible
State: Georgia
Job: Laid-off airline engineer 

I bought this plan because it had the lowest premium of all the plans available to me. The deductible is outrageous, and it doesn't really cover anything outside of a regular checkup. It's called the 'Catastrophic' plan because you only get meaningful benefit in the event of some catastrophic injury/hospitalization where you rack up a truly enormous bill. 

I'm 27 years old, with no real health problems, no prescriptions I take regularly, and no kids. In a lot of ways, things could of course be worse. When I think about buying this plan, the actual process of using the website and selecting the plan was pretty fast and easy, but the fact that I and so many other people have to do this kind of fills me with dread. I'm going to fork over $2600 (which I know is nothing compared to lots of people) next year for a plan that I hopefully never have to use to some giant insurance company who's absolutely going to try to screw me if I ever do end up having to use it. It breaks my heart that so many people suffer and go without proper medical care, or when they do get medical care they are crushed under overwhelming debt, when there is a much better, more humane way.