Affordable Care Act co-creater Ezekiel Emanuel, MD PhD, health economist Victor Fuchs, and Peter Orszag, former OMB director all have stated that the increased state Medicaid costs caused by the ACA have lead to less funding for state funded public higher education.  Thus, the ACA leads to even less funding for higher education.<p>Most developed countries that have universal care (eg, Canada, UK, France, ...) have high tobacco taxes to help pay for health care.  The taxes help to pay for the increased health care costs of smokers while also helping smokers to quit.<p>Our Federal tax is $1.01.