I think the costs saved by the Dead on Arrivals would probably offset the cost of long term care for helmetless riders.
There a lot of brain bucket/ novelty helmets sold here in NC. It's pretty obvious that they would not pass DOT. I haven't seen anyone with a novelty helmet that had put a DOT sticker on it. I believe there would be additional penalties involved if you are caught with the DOT label on a non-DOT helmet.
There's been a loophole in the NC law because existing law says:
"helmet of a type approved by the Commissioner of Motor Vehicles."
This posed a problem because they were not specific about DOT approval. Technically, a helmet was a helmet... the new law addresses this issue.