I find it interesting that a blog about self sufficiency and self reliance seems to have a large pool of followers that support passing their own expenses on to another. The expense being their own health insurance premium. I am not talking about pooling in the sense that my insurance carrier does but in the sense that some should get it free while others should pay through the nose.
I would just note that some of us are actually supporting paying for other people's expenses. My family are way over the income levels for subsidies, plus we do get very good employer-sponsored health care. We will hopefully continue to be in that position until we are eligible for Medicare. We also pay fairly high marginal tax rates. For me, it's not about wanting to get benefits for myself or my family. I just don't like watching other people die or go bankrupt because they can't afford medical care.
I understand that the person you are talking about may make poor financial decisions in other respects, but that doesn't mean she can afford health insurance. If she is single and would qualify for the Medicaid expansion, she is earning less than $16,000. Per the estimator, an exchange plan for a 35 year-old single person in Alabama (I picked a state at random) will cost a minimum of $200/month with a $6,000 deductible. So, she would have to pay more than 50% of her income in a year before her insurance kicks in. Even just the premiums would be at least 15% of her income.
If this is someone who could be earning substantially more money and chooses not to, I think you have a point. But you can work full time at minimum wage and be eligible for the Medicaid expansion. My opinion is that anyone who is willing to work full time is doing their part for society, and should have meaningful access to medical care.
ETA: Just noticed you are from Pennsylvania. Your friend should be happy - your governor just agreed to accept the Medicaid expansion.