Finally, state lawmakers should demand that federal officials be held  accountable for dumping billions in unfunded liabilities onto states.  They should apply maximum pressure on the Obama Administration and  Congress to explain how states are expected to implement PPACA without  appropriate funding or administrative guidance. This public pressure  will inform taxpayers of the incredible burdens that PPACA places on the  states and, ultimately, on them.  Moreover, it allows citizens to hold  the right people accountable for the poor policy outcomes created by  PPACA.
The difficult budgetary choices that states face in the years  ahead are yet more unintended consequences of President Obama’s health  care “overhaul.” Had the Administration instead pursued a federalist  model of health care reform, allowing states to be the laboratories of  democracy that the Founders intended, states could then focus their  energies on the innovative health care reforms that work best for their  own citizens. Instead, PPACA has left policymakers in capitals across  the country worrying about how to deal with billions in new spending  during already-harsh times.
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