When my prior employer pulled out of the area I had to look for health insurance options once my COBRA coverage ran out. I got a ACA plan that qualified for a HSA, still not cheap but as long as I didnt need a lot of medical procedures I got to bank money into my HSA. It comes out of my pocket as i currently earn to much to take a deduction on taxes. The first year it was close to 8.5 K, the second year it dropped to just over $7K. Built into ACA is the requirement that 80% of the premiums have to be spent on health procedures instead of admin and profits. Well last year they didnt spend enough on health care so they had to write me check for about a months coverage. I would rather pay less but at least the system works. I have another 3 years of paying for it before I can switch over to medicare. I plan to stop working entirely so with a bit of tax planning I can probably get to the point where I can write some of the cost off.