Of course they could always change this, but Americans living and working overseas, if they are outside the continental United States, they can get an exemption and do not have to pay for the insurance under individual mandate. Watch hundreds if not thousands of Americans nearing retirement, (or not for that matter) to be looking for safe haven overseas with jobs or retirement, to exempt themselves from the requirement, and the requisite penalities by the government for not having said Obama Insurance.
Yep, I may have to brush up on my Spanish, Costa Rica is looking better and better these days.