The ACA and Medicare are currently unrelated.
Medicare is for those over 65 and those who are permanently disabled. Typically Medicare covers 80% of your healthcare expenses, then you purchase a part B plan for the other 20% and Part D for prescription coverage, or a Medicare advantage plan which includes both. Your out of pocket expenses are much much less with Medicare, so high deductible plans are generally a non-issue once you reach 65. There is no deductible with Medicare part A.
Medicare will pay up to 3 months rehab, but nothing for long term care, which is not medical care.
The ACA insurance is for those under 65. My state does not have it's own ACA exchange. Subsidies kick in for us (two at 55 and one college age adult) for AGI over $70K. Of course the Supreme Court could change the game when it rules on the subsidies for those states without their own exchanges, but that won't affect us this year anyway.
It is possible to get insurance privately through places like esurance.com, but when I looked, my annual cost would have been $2-3K more.
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