Those who owe penalties would see their tax refunds docked. Not everyone who fails to buy insurance will be forced to pay up â¿¿ those exempted from the requirement to have insurance, such as prison inmates, would not be penalized, for example. That also would be the case with people who earn so little that they are not required to file a tax return.People owing the government a fine under the law could try to massage their tax returns to avoid receiving a refund, and thus the government would have nothing to claim. It's also possible people could try to exploit the religious exemption, for example, to avoid buying insurance and getting hit with a penalty. According to the government, the IRS plans to hold back the amount of the penalty fee from future tax refunds, but there are no liens or criminal penalties for failing to pay. ___ What are health insurance exchanges and how do they work? Exchanges are the online markets on which individuals and small businesses will buy private health insurance. Think of them as one-stop-shopping destinations similar to Amazon.com that are supposed to give consumers a quick way to compare insurance policies. But they might not be available to some consumers until later. That could leave many who lack job-based coverage to enroll by mail or through call centers. Still, consumers are expected to be able to see all their options in the exchanges and choose their health plans based on price, benefits and other features. Many participants will qualify for federal subsidies in the form of tax credits to help ease the cost. The amount is based on income and is available to individuals making up to $45,960, or $94,200 for a family of four. Shoppers will have different buying experiences depending on who is running their exchanges â¿¿ the state, federal government or a combination of the two. Enrollment begins Oct. 1, with health care coverage starting Jan. 1.