I have a Blue Cross plan not on ACA, but has same general rules as ACA, that pays the full cost for screenings including colonoscopies (they find I have multiple precancerous polyps each time). If I hadn't had the first screening 8 years ago in my early 50's because my doctor recommended and it was free, I would probably have colon cancer by now since they found a huge polyp then along with smaller ones and have since removed subsequent polyps every 3 years. Problem is genetic- lifelong habits of little to no alcohol or red meat and eat lots of fruits and veggies, exercise a lot etc. But my mom died of colon cancer after never being screened until it was too late. I had encouraged her for several years to be screened but she delayed too long. Losing such a warm and funny, vibrant and caring person who did so much for her family and community has been hard.
These colonoscopies removing polyps can cost thousand of dollars without insurance.
A friend signed up last year for ACA after being in excruciating facial and jaw pain from what they discovered was squamous cell cancer growth that he had postponed removing due to no insurance and no financial assets. It required tens of thousands of dollars of surgery and reconstruction as the growth had spread so far near his eye and jaw. So much trauma and expense would have been avoided if he had insurance before that provided routine yearly screenings and affordable removal of such skin growths early on.