The fine is smaller than buying insurance, it has more to do with removing barriers to people that couldn't afford insurance or had a pre-exisiting condition that prevented them from getting it.
Single payer would be better but that's for tomorrow.
Most counties have indigent healthcare plans for people that don't qualify for medicaid. It's paid for by the federal government primarily so even republican paradises still have them. It looks like NC doesn't do it though, but they do have this...