The post that was quoted here has been removedActually I was researching it this morning and it seems that and I believe that caissad4 has intimated that it is also the case that as a smoker she will be financially penalised by the health care act.
Under the ACA smokers buying insurance in the Exchanges will have to pay a 50% “Premium Surcharge.”
http://www.healthbeatblog.com/2013/05/the-affordable-care-act-and-the-smokers-penalty/
The situation has arisen that American hospitals which are two thirds owned by the government were closing at an alarming rate due to the sheer volume of use by those who were uninsured. Whether this actually is the reason I cannot say, but its plausible.
The number of public hospitals in major suburbs declined 27% (134 to 98) from 1996 to 2002. It is thought that the increase in uninsured has drained public hospitals to near bankruptcy.
http://en.wikipedia.org/wiki/Public_hospital
Now if it is the case then it is unsustainable and something needed to be done. I believe you are absolutely correct that those who are on low incomes will be adversely affected because of having to give up a greater proportion of their income to pay for the health insurance. Never the less by giving up smoking caissad4 has every reason to expect that her premiums will be reduced (she by doing so presents less of a health risk) and will be instantly financially better off as a consequence. Whether it actually permits her to afford health care is a matter of conjecture, but its awesome advice regardless and one must but sympathise with her predicament.
I also understand that if you dont pay you cannot be prosecuted and its not entirely clear how the government will collect your fine. I believe they have ten years to try to recoup the money in the forms of fines although admittedly i am a very poor lawyer and this could be balderdash.