Like I said: It's all screwed up. First fix is to expand Medicaid in all the states with idiot governors who created the Medicaid/ACA gap. I know all about that because my wife and I spent months fighting to get out of Medicaid and into the subsidized ACA. Fortunately, California does not have a gap and they claim it does not matter how huge a pile of assets you have. As long as your income is below the limit, you get Medicaid. I had to take some of my IRA to get my income high enough so we could get all of our ACA premiums back.