The federal Affordable Care Act's structure

Explain how your term paper/policy issue, though administered most directly by executives and agencies on one level of government, depends upon financing, legal authority and/or interagency coordination with other levels of government (e.g., the federal Affordable Care Act's structure that includes state exchanges and coordination with state Medicaid programs, which not all states have signed onto and some have sued over; education is locally delivered but with major state funding and federal mandates). Explain in more detail one fiscal, legal, or administrative connection between levels of government with respect to your issue.