The Affordable Care Act $(a.k.a.$ "Obamacare"$)is$ one $of$ the largest government programs ever implemented. $It$ uses

government subsidies $to$ try $to$ increase the percentage $of$ Americans covered $by$ health insurance. Which $of$ the following

statements most acurately describes what $is$ necessary for this program $to$ have a positive multiplier effect $on$ economic output?

Government spending $on$ the Affordable Care Act

cannot lead $to$ a multiplier effect because only increases $in$ private sector spending can create jobs.

cannot lead $to$ a multiplier effect because all healthcare subsidies must $be$ paid for $by$ higher taxes.

can lead $to$ a multiplier effect but only $ifit$ creates a net injection $of$ expenditures into the economy.

can lead $to$ a multiplier effect but only $if$ the number $of$ insured increases once the act $is$ passed.