Austin Frakt, a health economist who was a staunch advocate of the insurance mandate in PPACA, observes that there is evidence that the insurance mandate in Massachusetts is being “gamed.” But he doesn’t see it as a dire problem:

Massachusetts has about 6.6 million residents, of which roughly 6.4 million are insured. So, the number gaming the system is less than one-third of one percent of the insured. They’d have to account for over three times the average health care costs in order to raise average premiums by one percent.
The Globe article says the gaming problem is a $300 million issue or $47 per insured individual. Since a typical insurance premium is in the $5,000 range for an individual, this is not far off from a one percent increase. So, my thinking in the prior paragraph may not be far off.
I’m not suggesting we should ignore this issue because it results in a small increase in premiums. We should pay attention because it’s the best prediction we have of what may occur nationally. But if one throws in enrollment period limitations maybe it largely goes away. We shall see.

I agree on one point: we should not ignore this issue.