The ACA does force insurance companies to take you on as an insured, if you have a previously existing condition. But nothing the ACA did allows the premiums to have to be reasonable.
Nothing. So in my case, the insurance premiums are so outrageous, and not affordable, over $ 1,400 a month. So I can either give up renting a place to live or feeding myself, in order to have health insurance.
I could go to the California state setup for people like me, with just above minimal income. (and it's called PCIP or PIIP or some such.)
But even so, I have to pay some $ 1,100 a month and then consider this: there is a $ 2,500 deductible. And also co pays for both procedures, visits, and drugs. Most people over 55 are in this same boat with my household, unless they work for a corporation that pays their insurance.
Also the ACA did nothing to allow citizens here to start seeing drugs imported from Canada or elsewhere so the drug costs are manageable.
But now that the Unsupreme Court has ruled in its favor, there will have to be an extensive bureaucracy set up to see to it that everyone out there comply.
And don't forget - one way that the ACA programs should help pay for themselves is that penalties will be established such that anyone "opting out of getting health insurance will pay close to 700 bucks a year. The GAO has stated some 54 billions of dollars of penalties will occur between 2012 and 2022. Which is another way of saying tha those whose income is just a niche above the standards for help from the government will be paying a penalty.
And again, the ACA did nothing about preventing health insurers from offering their executives over 500 millions of dollars a year.