As with most insurance systems, for the Affordable Care Act to work it needs some people—specifically young, healthy people—to pay in more than they get out to make up for the people who take out more than they put in, Vox reports. The problem? Those young, healthy people are finding that "remaining uninsured is a reasonably good financial option." According to the New York Times, many people are deciding it's cheaper to pay the fine to the IRS for not having insurance than to pay premiums to an insurance company. And that's one of the reasons ACA premiums are going up next year. Not to mention that because the ACA allows people with pre-existing conditions to get insurance, nothing is stopping people from paying the penalty and then later getting insurance if something happens.
Tax and health policy experts say the penalty for remaining uninsured needs to be steeper—perhaps by hundreds of dollars—to be effective. For example, one man tells the Times he may "roll the dice next year" and hope his family doesn't have any medical emergencies because the penalty is one-sixth the cost of his insurance. And while penalties are doubling next year—from $325 to $695 for adults, CBS New York reports—it might not be enough. It's estimated 5.6 million tax returns will include penalties for being uninsured. (Read more Affordable Care Act stories.)