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Doesn't make since

If someone has the market place insurance and has a heart attack and informs the hospital of insurance but then the health insurance provider doesn't pay the bill so this person just doesn't go back to the doctor in fear that the insurance company won't pay again why does this person have to pay the tax credit back why doesn't the insurance company have to refund the money to the IRS ? Why does the tax payer have to pay it back when they didn't use it  

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