The question in this scenario is do you have cash, or credit, to handle the expense until then? If so no problem. However, the penalty keeps escalating and at some point it will be smarter to pay for coverage rather than care and penalty.
One approach to avoid having the govt decide what your care will be is to go outside the govt controlled system. Buy a plan from an exempted co-op that covers catastrophic problems and pay for the rest yourself. Concierge Doctors are becoming a big industry and people who don't want to be under the control of govt owe it to themselves to look into it.
Paying for cash or credit to handle the expense until then pretty much defeats the whole purpose of insurance.
A relative had meningitis in August 2010, which resulted in a stroke while being treated. By the time the next year rolled around, he had racked up a $450,000 hospital bill.