There are a couple of interesting graphs from Gallup that portrays the incidence of disease in the American lifestyle.

Among Americans with varying types of medical coverage (including no coverage), uninsured Americans are still the most likely to report having put off medical treatment because of cost. More than half of the uninsured (57%) have put off treatment, compared with 34% with private insurance and 22% with Medicare or Medicaid. However, the percentage of Americans with private health insurance who report putting off medical treatment because of cost has increased from 25% in 2013 to 34% in 2014.

When Americans do not have the money for healthcare they postpone it, possibly permanently.

The question as to the availability to health care by Americans should never be a matter of economics. Healthcare should be affordable and easily accessed.

This is a quality of life issue and directly relates to longevity.

...Thirty-five percent of lower-income Americans -- those with annual household incomes under $30,000 -- report putting off medical treatment in the past 12 months, down from 43% in 2013. More upper-income Americans, on the other hand, report delaying treatment, with percentages rising from 17% in 2013 to 28% this year. The percentage of middle-income Americans who have put off medical treatment remains roughly the same as last year, at 38%....

Where the impoverished have been able to access the Medicaid Expansion, it works.

Where the Medicaid Expansion is implemented, the percentage of income impacted by health care is far, far less. The Medicaid Expansion contributes to quality of life and longevity. For that reason alone it should be a national mandate. The ACA is a highly moral measure by the American people.

The idea health care can be postponed needs to be mitigated to bring timely attention to all Americans. In the question above the largest demographic postponing health care (Annual physicals and preventive measures are free.) lies in the private insurance market. It needs to be evaluated more closely.

If an American is postponing health care is it because of the commercial market initiatives of propaganda. How many Americans are listening to or questioning their doctors recommendations? There exists marketing strategies within the private sector of the health care industry to ? empower ? Americans to make 'educated decisions' that postpone health care. It is ruthless, but, then refusing care, as in the past, is just as ruthless causing unnecessary deaths.

Example: 

"Welvie before Surgery" (click here)

A subscriber that uses Welvie is given a reward in the way of a gift card annually.

It is designed to question doctor/surgeon's recommendations.

The ACA allows and almost insists Americans be educated about their health and options. That education component is abused by the health care industry to justify the increase in costs. 

The ACA was written primarily for physicians/nurses to educate their patients, not to hand the education to the very insurance carriers that at one time handed out death sentences of by refusing payment of costs.

The ACA cost is effected by the number of participants, but, also by the infrastructure the health insurance companies have built to justify increases in costs.