In recent weeks, many people have focused on the monthly cost of buying a health insurance plan in the insurance marketplace. What I’m talking about is different: The out-of-pocket costs they may face when they go to use that new policy. The president has promised to deliver affordable care to all Americans who want it. But the notion of what’s affordable may well be in the eye of the beholder. Many low-income people who haven’t had insurance before will qualify for subsidies to lower their monthly insurance premiums and reduce their out-of-pocket costs. And some with current policies will find that their new ones are indeed more affordable. But many won’t. Those on both the left and the right side of the political spectrum — and in between — acknowledge this may surprise consumers.