I agree with most of this except the affordable part, my wife today pays 150 dollars for insurance for herself, as well as dental and vision for the both of us. Her rates are set next year through her job to bring her up to about 200 dollars a month out of pocket for one person, while the cost from the exchange will be about 300. Something I encountered and I admit up front this is at face value, is that she may not be eligible for the lower rates due to the fact that I receive a cost effective coverage, that she cannot be added to. I have to read deeper into the rules, but basically what I saw is that both spouses have to be eligible for a subsidy. Each spouse must also be enrolled in a health exchange plan to receive premium tax credits, and in my particular house hold, I will not ever enroll in the government run exchange so, it will not be cost effective.