 [ Symptoms ] what causes acne [ Disease ] you make a fair point it is true that while the premiums are reasonable for people who qualify for a subsidy many plans do come with high out of pocket costs you can decide to pay the penalty    that is an option just keep in mind that these plans allow you to obtain preventive services at no cost at the time of the visit and if you have an accident or are diagnosed with a serious illness even the high deductible will be immeasurably less expensive than paying for care out of pocket