Yeah, grandfathered plan is the only thing I can think of - and that sucks. However, like I said, they can get a subsidy from the government exchanges if the employer plan offered is not ACA-compliant (and I think grandfathered plans do not count for that). If her hospital job's plan also offers insurance though, and it's ACA-compliant, then they're SOL as far as that goes.
If stepdad's insurance doesn't cover their pre-existing conditions, they need to get on a plan that will - either healthcare.gov without subsidy or her plan from her job. There is no "savings" to be had by cheaping out with his plan if it doesn't cover their needs - as they can see, they're already paying more. It's possible that they could still drop their work coverage and jump on an ACA plan through the exchange, as New York (and most states) extended the deadlines into April: http://www.cdphp.com/Health-Care-Reform/hcr-blog Clock is ticking though, and obviously this doesn't help with the current MRI bill. As far as that goes, do what BanetheBrawler said above - contact the hospital's billing department and open communications about charity care. They'll likely have an application to fill out where you list your income, assets, etc. and if they are as broke as you say, there's a good chance the bill will get significantly reduced. They should do that and see if they can get on an ACA plan as soon as possible - tell them to claim that technical difficulties prevented them from signing up earlier.
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