> If anything, it does insure you against catastrophic loss. ACA took away maximum benefit amounts.
This statement is nominally true, but it doesn’t stop insurers from trying.
For "emergency"-type catastrophic loss, it's not always clear when your "emergency" ends. Once stabilized, if you’re in an out-of-network hospital, you may begin to accrue costs that are not going to be covered. And of course, sitting there in your out of network hospital room, with out of network tubes in your body keeping you alive, talking to out of network nurses and doctors, your first thought should not have to be “how do I get to an in-network facility?” And when you do finally get home, and get balanced billed, and every conversation with your insurer starts with you re-explaining your heart attack, or stroke, or pregnancy complication, and you are on month three of $75k bills from your out-of-network hospital (in month five it goes to collections!), it is small comfort to know that your insurer is technically in violation of the ACA, and that with the help of a lawyer and your state’s insurance commissioner to sort things out, you might get them to reimburse your $75k payment to your out-of-network hospital.
For medium- or longer-term illness, this is more true, but the onus is still on the patient to stay on top of shifting networks and shifting plans, shifting adjusters, all typically while sick.
The ACA plugged a bunch of holes in the previous disastrous patchwork, including absurdities like annual and lifetime limits, pre-existing condition exclusions, plan nonrenewal on illness, etc. Those were necessary bandaids, but there are still holes.
Ask me how I know.