The opponents have a point when they ask, “If Washington can require you to buy this product, what can’t it require you to buy/do?” (This was not an issue for Massachusetts’s individual mandate, by the way, because that was a state program and there has never been a question about an individual state’s authority to set such requirements.) Yes, being a free-rider may affect everyone else’s costs, but even if you shun insurance, you still have to pay for the services you use, at least if you’re non-indigent.
For many people, non-participation in the health-care risk pool is economically rational, and participation is not. For others, refusing health insurance might be a “statement” of sorts. There are a few Americans who want as little contact as possible with authority or the wider society. They prefer to live “off the grid.”
In other contexts, we applaud the exercise of the “right to be left alone.” Indeed, radical individualism, or, to be more precise, the possibility of radical individualism, is part of what’s always been different and, to many people, kinda special about America. As a practical matter, the scope for this kind of life has been diminishing for some time. The individual mandate limits it even more, in favor of social solidarity.