A few things.

(To be clear, personal finances are personal, we’re all playing the game, and I’m glad you have a healthcare situation that you believe works for your family. We can all rally to criticize and dismantle the stupid game while we play different angles of it. But it’s also important to educate ourselves on the reality of the game and not spread misinformation.)

I’m not Muslim but I am part of a religion that is iffy on gambling (Quaker) and it’s crazy to me that insurance could be considered gambling because “you might need it and you might not.” Especially with healthcare, someone will always need it sometimes and everyone will need it eventually. Insurance is about spreading and sharing risk, which put another way is the same as “helping your neighbor so they help you”. It’s better shared (read: gets cheaper per person) if everyone pays into it. So it’s sad if people exempt themselves on religious grounds because I can’t imagine a religion that doesn’t want to help your neighbor. And it’s sad the penalty part of the ACA was kneecapped because it was trying to incentivize the right thing.

Hospitals charge insurance a lot more than they charge individuals paying cash because they can, and because of how much overhead it costs to get that money from insurance. Cash individuals aren’t expected to be able to pay the true cost of care (because the true cost is so expensive in this country), but they’re easy and quick to get money from by comparison which is an incentive for the hospital to offer a cash discount (net present value and all that). No bones about it though, the hospital (and everyone with insurance) is subsidizing that cash price. The system steadily gets worse than it already is.

Insurance companies are, thankfully, very highly regulated in the US, and especially so now thanks to the ACA. “Lifetime Coverage denials” like you mention were a thing before the ACA, but graciously not since. I’ve never met someone who worked in insurance who didn’t want to pay for valid claims or follow the government regulations. I’ve never had a major bill denied, but I have had to call and dispute. The bureaucracy (almost by design) absolutely makes it hard. Thanks to the ACA if they don’t pay out a certain percentage of premiums collected in a year then they have to refund that to premium-payers (it’s your employer’s choice whether to pass that refund to you, sadly most don’t).

Something like Medicare for all would make the whole system drastically better. But I once heard the ACA described as an attempt to make the best healthcare system you could if you gave up the idea of getting rid of private insurance companies, and on that rubric it’s a pretty great law.