@drspouse The exchange plans are quite complicated. Subsidies are calculated based on silver tier (bronze is almost always a terrible buy). There are additional subsidies for out of pocket costs as well. So you can't judge what someone will pay by a chart.
There are gaps in the ACA. For one there is subsidy cut-off, which cuts off at an income level that sounds quite decent but isn't enough to pay the full cost of insurance, especially for a family. This hits a rather narrow slice of people who make a decent amount of money but are self employed or have employers who don't subsidise their premiums, but it's an issue. And of course the states that chose not to expand Medicaid, because if a state does that, people who should have been covered by Medicaid can't access exchange plans.
There are significant issues with the US system: the differential payments between systems, the lack of cost control, hospital consolidation, I could go on! But insurance access has improved significantly.
Public transport is an issue. I live close enough to DC to be a quick drive from a Metro station. Some cities are better than others. Older inner-ring suburbs, especially in the Northeast, are more likely to be partly walkable.
The US is ugly? That's just laughable, sorry. It's bloody massive.