Akenton, single payer would be better, but this is the compromise we got.

How can one force people who are on the breadline to pay for insurance that they may never use?

Umm, they did think of that... "people who are on the breadline" qualify for Medicaid or other assistance with affording payment.

A basic explainer, for those who missed it a couple years ago:
Health Reform Explained Video: "Health Reform Hits Main Street" (video) or
Illustrating Health Reform: How Health Insurance Coverage Will Work (web page) (these both from the Kaiser Family Foundation).

~ Becky in Tucson