I would like to add another real-world experience with the Patient Protection and Affordable Care Act. Prior to the ACA, a woman I assist who is on a fixed disability income was paying zero out of pocket for her Medi-Cal. After the ACA kicked in on Oct. 1, her of out-of-pocket expenses per month before insurance pays a dime is $689. This is more than half her monthly income. She is at a zero tax bracket, so no tax benefit to her.
This is not affordable under any circumstances. This is horrific. A call to the ACA staff at Covered California rendered me this answer: We are very sorry. This is just the way it is.