The big difference for me at the time I was freelance was that there was actually a point to getting insurance. Pre-ACA if I got a serious mid to long term illness my insurance company would just drop me anyway. Although once ACA was enacted it was still kind of pointless in that the deductible put me in a position where unless I got a mid to long term illness I'd never use it. So in reality I just went without and planned to just declare bankruptcy if anything bad happened. Bonus of the new ACA era is that I could just wait for open enrollment(hopefully I would get really sick at the right time of year) and pick up a gold/platinum plan if I did end up with something that required long term care.