@Mugsy Brogues I'm know that the federal government issues regulations in the past 6 months which would require student health plans to meet similar requirements regarding actuarial values, benefits, and out of pocket-max's that the other qualifiable plans will have to meet. I don't know enough about student health plans and their interaction with the ACA to comment on whether you will be able to apply for medicaid while in grad school. I have read that the new requirements on student plans may lead to many schools dropping their health plan, so this may open up the exchange plans for you. If you want, shoot me an e-mail with some more specifics on your situation and I'll see if I can get you a better answer.
@mulligan If your state does not set up a health insurance exchange, the Federal Government will set one up which you can use to purchase health insurance. I believe there will still be the subsidies. However, because of the SC decision, they don't have to expand Medicaid. However, opting out on this will loose them a great deal of money, which states are reluctant to do. I anticipate a lot of states that claim to opt-out, will opt back in when the reality of loosing out on federal funds becomes a reality. If your state does actually opt out, and purchasing health insurance will require greater than 9% of your income, then you will be exempt from the fine for being uninsured.
@jfruh There will be out of pocket maximums. Check out the chart on page 4 of this document - http://www.kff.org/healthreform/upload/8177.pdf
@jfruh I'll try to answer some of the questions to the best of my knowledge and using Massachusetts as a model. The tax subsidies will likely be taken out of the premium. What will happen when you enroll is that there will be an income projection at the time of enrollment. Based on the determination they will use that to figure out where your subsidies will be, and when you enroll they will be automatically deducted from the premiums. That projection, and the methodology, will be very important in establishing these exchanges. They may not just be self attestation, but require a certain look-back period for determining income level. Accuracy is important because if it is inaccurate there may need to be an end of the year reconciliation, which would be awful and make people not want to enroll in the first place. This method will develop over the next year as the realities of implementation come into focus.