One of the reasons policy implementation is problematic and cumbersome is that many federal policies are implemented at the state and municipal levels, making them difficult to monitor

Which was used as evidence of the need for the Patient Protection and Affordable Care Act?

a. Private insurance companies are adequate for providing health care coverage to most Americans. b. Uninsured Americans have access to health care because hospitals are required to treat patients with life-threatening conditions. c. Health care costs have risen substantially over the past few decades. d. The government generally operates more efficiently than does the private sector.

Since 1789, when the states ratified the U.S. Constitution, the national government's scope of responsibility for domestic matters has

A. rapidly contacted. B. gradually contracted. C. remained constant. D. rapidly expanded. E. gradually expanded.