RALEIGH – The passage of ObamaCare didn’t represent the culmination of the national debate over health care – or even a high-water mark of political controversy about it. Those who favored increasing the federal government’s control over health care financing and medical decisions intended to make them more political, not less.

That’s what they’ll get – but I doubt they’ll like the result.

Here are some of the latest developments:

Health Care News reports that more than 20 states have decided not to participate in the transitional, federally funded high-risk pools authorized by ObamaCare. Unfortunately, North Carolina’s leaders decided to dance to Washington’s tune.

Here’s how Minnesota Gov. Tim Pawlenty explained his state’s decision not to participate:

“First, philosophically, we do not want more and more things taken into Washington, DC and run by a federal bureaucracy with centralized decision-making, one-size-fits-all approaches, and big, bureaucratic systems. We want to keep as much of the policymaking discretion at the state level where it impacts. We in Minnesota have a successful, nation-leading program and model in this area, and we didn’t want to turn the keys over to the federal government,” Pawlenty told Health Care News.

“Second, there were really no assurances about whether the new federal approach or standards would work or be any better than what we have now. In fact, we believe they would be worse. And third, it was likely the federal government would not finance this in a way that wouldn’t prove detrimental to the states.”

• Americans with health insurance are consuming fewer medical services than they did last year, reflecting a combination of factors that includes the rise of high-deductible health plans that discourage wasteful consumption of care, reports The Wall Street Journal.

Some 18 million Americans are enrolled in such plans, up from 13 million last year, and millions more are enrolled in other forms of consumer-driven health plans that give them information, choice, and financial incentives to consume medical services more wisely.

Unfortunately, ObamaCare will hurt the growth of health savings accounts and consumer-driven plans – and depending on how federal regulators interpret the law’s mandates and tax provisions, it may invalidate existing plans or making it impossible for insurers to maintain them because of restrictions on selling new policies.

• ObamaCare continues to be very unpopular among likely voters, according to the latest surveys compiled by RealClearPolitics. Typically, polls of all adults or all registered voters show a modest plurality of respondents expressing disapproval of ObamaCare. But when the sample is screened for likely voters, support drops into the mid-30s and opposition into the low- to mid-50s.

• Opposition will grow, not shrink, over time as Americans learn more about the details of the law and how it will affect their current health care arrangements and future medical costs.

In Arizona, for example, state officials project that state employees will see their health care costs rise by as much as a third next year, due largely to the implementation of the initial stages of ObamaCare. And in Kentucky, hospital officials project that the Medicaid expansion at the heart of ObamaCare will cost hospitals more than a $1 billion over the next decade.

• Small business will be particularly hard-hit by the economic costs of ObamaCare, despite promises to the contrary. As Health Care News reports, the tax and regulatory effects will force some firms to change their health plans, induce others to drop them entirely, and reduce employment.

There was a better way to proceed with health care reform – a strategy based on empowering consumers, promoting competition, and keeping as many medical decisions as possible out of the hands of politicians and the special-interest groups that manipulate them. But Congress and the Obama administration chose a different path.

While they may well pay a political price for their decision, the rest of us will pay an even-bigger price out of our wallets, our freedom, and our health.

Hood is president of the John Locke Foundation.