“As the Affordable Care Act (ACA) celebrates its third anniversary, the law has already imposed $21 billion in private-sector burdens, $9.8 billion in unfunded state liabilities, and 111 million paperwork burden hours. When the American Action Forum (AAF) reviewed the law’s regulatory impact last year, the ACA had imposed a combined cost of $12.4 billion and 50 million hours, meaning in the last year the administration has more than doubled the cost of implementation and added 21 million compliance hours.”