I just spoke to a coworker and this is who the ACA is for. His mother has become disabled and her monthly premium was more than she was getting in her disability payment. No "insurance company" would offer her insurance because of her preexisting condition. Some fly by night insurance company picked her up and she was paying through her nose just so she could get her medications. It took her 3 weeks to register but once she saw what her insurance was going to cost with the subsidies she started to cry. She is so happy now. She can actually live again.