There's a huge set of caveats for the maximum out-of-pocket. The maximum is only for "in network" care. You can very easily end up with out-of-network care for various reasons (including going to an in-network hospital but being treated by a doctor who is out-of-network without being informed of this fact). Maximum out-of-pocket for out-of-network is $40k per person per year on my insurance.

We have ACA now, anyone can get affordable insurance.

The conundrum is that anyone who can afford to shell out $500+ a month for the most basic plan doesn't need it / probably has a better plan through work. The complexity and cost of the band aid system we have now is a joke the world over.

Tell that to the millions of people who live in states that never expanded Medicaid under the ACA.

No, they can't. When I was poor and working full-time for $15/hr the best I could get was a bare minimum healthcare plan that would have taken more than the free money I had after rent and food for the month -- and this was despite not paying any cost for transportation to work and not owning a car or buying anything besides rent, food and the cheapest MVNO phone plan I could find.

I didn't live in a high CoL area either. Everyone who isn't wealthy or socially connected to get a job that pays above average is priced out of visiting a doctor at all right now.

Sure, if you have $500 a month laying around no problem.

In many states right now, there are zero cost premiums for those who make within 200-250% of the Federal Poverty Line. Percentage varies between states, or sometimes even by counties. This was part of Biden's stimulus package and should help a lot of people.

Yes, and there are a lot of people trapped in the land of "can't afford the insurance, but also don't qualify for subsidies."

In many states. Not in all.

I mentioned it wasn't in all states. But it's still going to affect the premiums of millions. It's a good thing.

This is ludicrously far from the truth.