The recent IRS ruling has really thrown a huge cost increase in costs to the poor and middle class, for sure. It is already being challenged in court and we hope it'll be struck down.
People who drive must have insurance because when they get hurt and/or hurt others in an accident, the rest of us get stuck paying their bill. So the ones who refuse to pay for insurance will still get emergency medical care, but it's not fair to everyone else who does take the responsibility on of paying for insurance.
The penalty for not buying into some plan will likely be approximately 1 - 3.00 USD per day, far less than what people who have insurance are already paying. Nobody at the federal poverty level will have to pay any. Also, both medicaid and medicare are being expanded to cover a lot more people.
People without medical care still end up in our emergency rooms, only more ill and costing the taxpayers far more because we're footing the tab for the much more expensive ER care. It's bankrupting our hospitals. Doctors who treat medicaid patients only get reimbursed 88 cents on the dollar, so most practices will only see a certain amout since they pay for it.
The insurance mandate assures a large pool paying in so coverage can be given. It may seem unfair, but it's going to be far less of a tax penalty than having one bad illness or emergency and going bankrupt. It's economic protection for families and the consumer, and will keep hospitals open.
There's nothing fair about our free market system now. Only those who can pay get care, unless it's expensive care via the ER that those who are working pay for. There's plenty if unfairness going around but at least most will be able to get primary, preventative care, and no more heart attack patients would go bankrupt within two years, unlike what happens now.
Over 1/2 of all bankruptsies are medical bankruptsies. The taxpayers pick up the tab for those, and it's killing our economy. It must be addressed. Nobody should go bankrupt because they got sick.