Yes. There was this thing amongst conservatives in red states that Obama was why prescription drug costs went up after the ACA, therefore the ACA was bad.

It was good enough here in Maryland (and certainly night and day compared with Florida's "if you get sick, better die quick" model that I was coming from). But my memory is that the best version of it was when I was completely jobless and went on Medicaid. Once you got on a private health plan, the subsidies were nice, but the bureaucratic bullshit that comes from interacting with the insurer is still a gigantic pain in the ass. Which is pretty much what you'd expect from a public vs private insurer. (And why I wanted a public option in the ACA).

I am anticipating that our state exchange will become enshittified to resemble the Colorado model.

P.S. Governor Shapiro was recently pilloried for going on Ted Nugent's podcast because he wanted to center his "you can now shoot deer on Sundays in PA" credentials.

I bought off the CO exchange and it's not as good as NY but it's not terrible. The massive downside is that it is CO only and emergency care everywhere else. My NY Blue Choice plan would let you use Blue Choice providers all over the US.

What your friends might have done is gotten into the claws of a scammy "we can get you insurance on the exchange" agent who advertise on the Internet. I did that and yes, the calls were endless and it was a high-pressure sales job when I talked with one of the agents. I used an agent in CO and she was awesome, but I picked one who had a physical office near where we were living.

A couple's (longtime friends) son in his mid 30s, is an independent contractor. He is newly married with new mortgage payments too. Got a cut, then a serious blood infection, had to be emergency airlifted from local hospital to a better equipped medical facility, and was hospitalized for a long time. No insurance! My friends were on the hook for his gargantuan medical bills AND made his mortgage payments until he recovered enough to help pay both. They had just paid off their mortgage at the time, thankfully. I'm betting their son is now insured although I haven't asked. Needless to say, their retirement has been delayed to "never."

ETA if I do have a catastrophic medical event, I can withdraw from the invested inherited funds. But I will fight like hell with the billing administrator first, or maybe let it go into collection, and try for a pennies on the dollar settlement with the collection agency. I don't use credit at all for anything so I don't care about my credit report.