OK. So what if you just don't pay. Suppose you aren't in a protected class, but you just don't pay. As I recall the law, the IRS can't collect these fines, although it can levy them. What happens then? Free medical care? AN escalating IRS debt? Do they partition the debt between back taxes of the usual kind and back medical mandates? I just don't get how this is supposed to work (although I know I'll get screwed and pay for it anyway).
As to the IRS they will levy the fines and withhold the fine from any refund or government benefit you may receive. I believe the IRS is prohibited from taking what they call “collection action” but they are not prohibited from withholding the amounts from any money you have due. Also they will put you in the CAIVRS system as owing a debt to the government preventing you from getting government backed mortgages. They are plenty of other ways they will dun you without actually initiating a “collection action”.