Affordability tests are based off what you’re projected to make and if you have any income or savings at all, that can impact that directly. Moreover, depending on your needs, the cheap plans might not work out. If you’re diabetic and require insulin and testing strips and other stuff, a high-deductible plan probably isn’t going to work out. The same is true if you’ve got specific prescriptions you need covered that are only up to a certain amount on a lower-tier plan or aren’t available unless you pay more. So in some cases, the ACA plan could cost the same as COBRA, and you’d be stuck starting from zero with your deductible, which if you had paid into under your employer, could be significant.
But beyond that, let’s say you anticipate you can make $3000 a month freelancing. Now, this isn’t enough for your rent and your insurance, but it’s still too high, perhaps, to qualify you for a lower-rated ACA plan. And it is certainly too high for Medicaid. So if you live in a high-priced city, you’re now stuck having to decide what you pay for — and that’s not always easy. Remember, it’s not like moving is that easy — you may have to break a lease (which costs money you don’t have), and you’re unemployed so signing a new, less-expensive lease is going to be challenging too.
The safety nets we have in place are really only designed for the very, very poor (and even then, they don’t go far enough). If you are anything but that — you’re really fucked, especially if you live in an medium-size or larger city/urban area.
