Replying with a throwaway for obvious reasons. I work at one of the big tech companies -- I'm paid well, but the benefits are very good. I just got an offer from a startup that I really like. It's a job I would like to take.
I'm going to have to turn down the offer. Part of the reason I'm going to have to turn it down is that even though it offers insurance, its coverage isn't as good as what I have and the subsidy offered will add $15k a year minimum to my health care expenses. My partner needs surgery (an expensive surgery), and I'm the primary bread-winner (for now) -- I have to make pragmatic decisions because of stuff like healthcare, even at the expense of my own aspirations.
And to be clear, my scenario is significantly better than so many others who are stuck in truly terrible places (where I work is not terrible by a longshot) or in careers they would like to change, because the truth is, health care in the US is a joke.