Best strategy to survive self-employment

I want to form a startup, planning on very little income at the start (say in the 40k MAGI range), but I’m sort of freaked out about having to switch to an HMO plan. All the ACA plans in my state (Indina) are HMO. I’ve only had PPO plans in the past, through employers, aside from one 3-month period on Kaiser HMO, which sucked.

I’m 47 and actually need to see specialists sometimes and I assume HMO will deny basically everything. How do people manage? Are there some HMOs that are actually ok or is their goal basically to kill me if I’m unlucky and get cancer? Or at the first sign of trouble do I need to move to Europe?

I’m American and lived here my whole life but suddenly surviving to retirement and beyond seems almost untenable as I imagine getting older and having utter crap for insurance. it seems truly crazy that the best plans (PPO, which still isn’t perfect) are only available for W2 wage slaves. I thought we promoted entrepreneurship here! I know I sound like a lunatic but I’m honestly freaking out since I was excited to form a company but didn’t realize I was going to be forced into some crazy HMO where all the good doctors are apparently not available.

Also I heard about this faith-based cost-sharing group as an alternate that would provide a PPO plan, but it was recommended to me by an insurance broker. If the only options for insurance are plans in the ACA marketplace, I’m not sure if the broker is unbiased or else incentivized to upsell me on alternates like that cost-sharing group, since the broker presumably wouldn’t have any incentives/kickbacks from the ACA plans.