I cannot comment on your anecdote, as you know. I cannot specify the precise reason why an exchange plan is so much worse for you, though I expect it is because you don't qualify for subsidies and may voluntarily do away with some of the compulsory coverage.

Can I make an old-fashioned suggestion: whether ACA is any good is not a popularity contest. So the church mouse is being looked after. Good. One of the signs of a decent society is that it also looks after people who prove incapable of looking after themselves. Big deal- what real impact does it have on your lifestyle?

>>When I had my hip replaced, in spite of the fact that I pay a fortune for my insurance, it still did not cover everything. $1700 came out of my pocket.

If you were most anywhere else in the free world, you could decide whether to wait a little and have your op for free, or pay some money (or have optional health insurance) so the same surgeon could do your op in a private setting. Also please consider the existence of "medical tourism" where it is tens of thousands of dollars cheaper to take a 6-week 4-star vacation to (say) New Zealand where the cost of your hip replacement is 20% of the US cost and the quality according to the Commonwealth Institute is slightly better. The funding of your system is thoroughly messed up and you seem irritated to pay for the church mouse- but her costs are as nothing compared to the mega-bonuses and dividends flowing furiously out of healthcare into already overflowing parasitic pockets. I promise you- let these people drive your system for another decade and the banking crisis will look like a minor blip.