WRT the $95 penalty—apparently the only way the IRS can get it out of you is if you are eligible for a refund.
For people who would be eligible for Medicaid (low income)....they would not have to pay the penalty if their state did not expand their Medicaid program. Many states didn’t.
But many low-income do get a tax refund....even so they would not have to pay because the state didn’t expand their Medicaid....
In Pa. under exceptions it reads....”You qualify for Medicaid under the new income limits established by the Affordable Care Act BUT, because Pennsylvania has not expanded Medicaid eligibility, you cannot take advantage of these rules.