As of January 1st, I'm on a non-exchange plan that I'm only able to get because of the ACA (I was previously uninsurable on the individual market due to preexisting conditions). I'm off-exchange because the best plan for my particular situation isn't offered on the exchange on my county, and I wouldn't be eligible for a subsidy anyway. (You do know that if you really don't want medicaid and can afford the premiums, you could just go to an insurer off-exchange, right?)
I have family with limited income who went through the quick signup process on Washington's exchange site and got put on Medicaid. Card and related information showed up soon thereafter. No big deal.
Seems like you've got some sort of mental block. Your comments haven't mentioned any practical problem, yet you seem unable to get past some unstated obstacle.