But what does this have to do with the ACA costs? Is this just "the government is spending on this other thing rather than this thing?"
The government subsidizes a portion of ACA payments depending on income in America. Without the subsidies, it's unaffordable for probably 95% of the population. That's why most people rely on employer-sponsored healthcare.
But what does this have to do with 80 year olds and end of life care?