"With Obamacare I pay 24,000 in premiums, 3000 per person deductible and 18000 max out of pocket."
With those numbers, I can roughly tell your age and marital status.
Do you need the Marketplace? In general, the first rule of Obamacare is only use it if you're getting a subsidy; there are often better, cheaper plans available OUTSIDE the Marketplace.
Also...I can relate about hitting the max OOP based on a specialty drug. After my heart attack, I was placed on Brillinta, at $1,100 per prescription. I remember in October handing over my credit card (after offering blood from my arm) and the pharmacist said, "Oh, no charge...you've reached your annual limit".
If that happens to you, do what I did: schedule every possible doctor's appointment you need before the end of the year! I got vision tests and audiology tests, leading to a $6,000 pair of hearing aids costing NOTHING out of pocket.
" Is RFK Jr's nomination just another step in Pres Trump's apparent goal of killing off Americans? ..."
Reminds me of George Will's question, updated: If Donald Trump was sent to destroy America ... what would he be doing differently?