Canadian and also the article is behind a paywall, so forgive my ignorance but what is stopping them from signing up for Obamacare?

Also just my own experience, I've been really sick the last 3 months, had a cold that turned into a sinus infection, 4 doctors visits, all I had to do was pay $50 bucks for nasal spray and antibiotics. Got sick again last week, and have been coughing a ton, my right side started hurting like crazy last night and I thought I had appendicitis or a muscle pull, felt like a knife going into my side every cough. Went to emergency, no appendicitis, it's a pulled muscle, sinus problem not bacterial so no antibiotics, tough it out with some acetaminophen and ibuprofen. Cost $0. That was my first emergency visit in 15 years since I sliced my leg open so I'm not abusing it, I was in serious pain. Nice to know I didn't have to choose between paying my bills and what could have been dying from a very serious appendix problem.