Don't act like ACA is some magic pill that solves every problem with no downside. It has good and it has bad. I know some people who got health insurance on the exchange and would still be begging for money for medical bills given the high deductibles they would have to pay before anything kicks in.
If they make less than 250% of the poverty line, the government also pays a portion (on a sliding scale) of their copays and deductibles, in addition to their premium subsidies.
If they make more than that, they should be able to afford the deductible.
Obviously you know more about your friends' specific situations that I do, but the fact remains that people under 400% of FPL using the Exchanges generally shouldn't have higher bills, either in premium or cost-sharing, than they can handle. It's the people who make 401% of the poverty line who are screwed.
