obamacare (the ACA) is not a type of care you can enroll in
state marketplace plans, the kind the ACA promotes, existed before obamacare/the ACA
you have to make a certain minimum income to qualify for state marketplace plans the same way you do for most financial things that exist in the united states. if you do not make that much, you can choose to enroll in medicaid. this is entirely optional and you can still choose to just not have health insurance entirely, or to use employer-sponsored health insurance only if you have it.
what the ACA did was ban insurance companies that receive federal govt money from raising rates based on preexisting health conditions, expand medicaid eligibility, and require state marketplace plans or medicaid to be available to everyone without employer-sponsored insurance. prior to the ACA you could not get an insurance company to cover you at all if you had certain health conditions, and not having health insurance in the US means you can be denied medical care. So people literally died because they were refused lifesaving care when they didn't have insurance, and even if they could afford it no insurance company would cover them.
prior to the ACA, you had to avoid diagnoses as much as possible in order to not have your insurance rates raised or lose coverage entirely
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