This means that as many as 45 million people in America live below the poverty line. To find a way to improve this, President Obama created the Affordable Care Act which enforces everyone to have insurance, either by receiving Medicaid or Medicare from the government or paying out of pocket for health insurance. Yet, even with insurance, many people are still unable to afford to pay the deductibles and copayments. Thus, socioeconomically disadvantaged people may opt out of going to their primary care physicians for routine check-ups and treatments for maintainable diseases such as diabetes mellitus or hypertension. Yet, if these diseases are not maintained to a certain degree worse symptoms and conditions will start to appear, such as renal failure, heart failure, or a stroke. In the end, this will cost much more for the patient in hospital fees and will leave the patient in worse health