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You can still get ACA subsidies if you fall within the income level it's not means tested, they absolutely designed it this way to be gamed. Also qualified distributions from a ROTH IRA are not considered part of modified adjusted gross income.

So do your mega-backdoor ROTH conversion and take out of that and it doesn't count against the insurance-company subsidy.

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The subsidies don't help with copays, deductibles, and co-insurance, right? Those can run into the five figures even on a "silver" plan, in a bad year. If someone on the plan gets cancer, congrats, now every year is a bad year.

that's partially true, but... 'retiring' on $100k year is still potentially disastrous if you have a major health issue.

Sure, yeah. My point is mainly that expenses for early retirement in the US have the potential to vary a lot compared to... well, basically any other OECD state, really, mostly due to healthcare. This makes the lower bound for a reasonably-safe early retirement quite a bit higher, such that merely generating enough safe-withdrawal income to live on in a good year isn't enough, even if the markets do exactly as well as you're counting on and that income's steady.

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