When this was first required I couldn't afford health insurance through my employer. When I was doing my taxes myself online I had been able to claim religious exemption and avoid the penalty with no proof needed. I don't know if this is still a thing but it got me through a few years until I got a better job with affordable insurance.

Article According to this report she was in an intensive 5 day a week program for PPD. The father worked from home to help support her. It just wasn't enough.