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Individual attitudes and opinions may visibly impact upon an individual's decision on how and when to use health care services and associated decisions with respect to medical expenditures. These health care preference measures also serve as important inputs in helping to predict health insurance coverage take-up decisions. This study provides a detailed investigation of the degree of concordance over time in health care attitudes regarding the need and value of health insurance coverage based on national data from the Medical Expenditure Panel Survey. Attention is also given to the alignment and associations revealed between the degree of concordance in health care preferences and the persistence in individual coverage and expenditure patterns over time. The utility of these preference measures as significant predictors that serve to identify individuals with persistently high levels of medical expenditures over time is also assessed. The Affordable Care Act was enacted with major provisions to expand health insurance coverage, control health care costs, and improve the health care delivery system. The analyses conducted in this study provide important insights regarding the significant influences exerted by health insurance preferences upon forthcoming coverage enrollment decisions and related interactions with the healthcare system. [ABSTRACT FROM AUTHOR]