This was predicted by anyone with a brain - pay the penalty, which is cheaper than the insurance, then pick up the insurance if and when you actually need it, because you can’t be denied for pre-existing conditions.
All it takes is enough cash or credit to cover initial expenses in an emergency until you can get the paperwork through to cover the rest.
They must be really stupid though to pay the penalty. There are so many exemptions that you can find or create one. Just don’t pay a utility bill until you get a shut off notice and bam! Exemption.