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If you can't afford a trillion dollar healthcare program, you don't sign the bill. Obama pushed it through when he should have done everything he trying to do now instead.
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Many development economists would argue that you can't afford NOT to implement a broad-based healthcare program. For many of the hated social programs among the right, there are solid economic reasons to support them and for the government to pay for them. Health is a good example, a healthy population is a productive population and even if it's expensive it could make you a wealthier nation based on different welfare indicators. Health in this view is seen as an investment with gains in productivity, happiness, etc being the returns. Same goes (even moreso for education).
Maintaining a healthy population or at least starting the process of reforming the incentives in the current system to reduce the costs is an expense that I would argue the government couldn't afford to neglect.
And your statement is highly revealing in just how down the road some people are. "If you can't afford it then don't do it." The U.S. is the richest country in the world. How could it "not afford" to do it? What's more appropriate is what are people willing to pay for? A slight increase of taxes or closing loopholes could pay for the system. You can afford to do it at that point.