TaxProf Blog

Editor: Paul L. Caron, Dean
Pepperdine University School of Law

Monday, August 17, 2009

IRS: The New Health Care Enforcer

William A. Jacobson (Cornell), IRS: The New Health Care Enforcer:

People often joke that government-run health care will have the efficiency of the motor vehicle department, and the compassion of the IRS. This joke will become reality if present Democratic health restructuring proposals are enacted.

Under both the House and Senate Health, Education, Labor and Pensions (HELP) Committee bills released to the public, the Internal Revenue Service will play a key role in monitoring and enforcing health care mandates against individual taxpayers. Yet the introduction of the IRS into the health care system has received scant attention.

The Senate bill imposes a new requirement that all persons who provide health care coverage to others must file a return with the IRS listing the names, addresses, social security numbers, and the coverage period for each person, and "such other information as the Secretary [of Health and Human Services] may prescribe." (Section 161(b) starting at page 107). The bill does not limit what information the Secretary may request, so it is conceivable and likely that information as to the nature of the coverage, the family members included, and other details will be reported to the IRS.

The House bill contains similar provisions in section 401(b) (at pp. 175-176). ...

These reporting provisions would allow the IRS to cross-check income tax returns and health coverage filings, and withhold tax refunds or utilize other collection methods for persons who do not have coverage unless they can prove they have acceptable coverage from some other source. This is similar to the cross-checking the IRS does on income reported separately by the person making the payment and the taxpayer receiving the payment. But for the first time the IRS is not checking for income to tax, but for lack of health coverage.

These provisions should have people interested in privacy greatly concerned. While income information already is reported to the IRS, the IRS traditionally has not received personal health care information about individuals.

The IRS involved in health care monitoring and enforcement. Somehow, I doubt that most supporters of Democratic health care restructuring concepts will like this detail.

(Hat Tip: Daniel Messing.)

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