In some of these cases with children receiving care the family income is just a small amount past the set income limits for public programs ( this is common) but the family is far from well off but they can buy the premium from the ACA and no one is turned down for a pre-existing condition ( this case diabetes)  which if you understand the reason for the ACA and it was created to cover people who were not able to get health insurance from their jobs or had just a bit more income than the set income guidelines for welfare programs like medicaide.  Childhood diabetes is a vey serious condition and often leads to early death due to complications.  Children who have type 1 diabetes need a lot of medical care all their lives, I can see why this mother is standing outside holding her sign, she has been through a lot that many people would not begin to understand. Her child' life depends on having expensive medical care.