WASHINGTON -- The Supreme Court's decision to uphold most of President Barack Obama's health care law will come home to roost for most taxpayers in about 2 1/2 years, when they'll have to start providing proof on their tax returns that they have health insurance.

That scenario puts the Internal Revenue Service at the center of the debate, renewing questions about whether the agency is capable of policing the health care decisions of millions of people in the United States while also collecting the taxes needed to run the federal government.

Under the law, the IRS will provide tax breaks and incentives to help pay for health insurance and impose penalties on some people who don't buy coverage and on some businesses that don't offer it to employees.

The changes will require new regulations, forms and publications, new computer programs and a big new outreach program to explain it all to taxpayers and tax professionals. Businesses that don't claim an exemption will have to prove they offer health insurance to employees.

The health care law "includes the largest set of tax law changes in more than 20 years," according to the Treasury inspector general who oversees the IRS. The agency will have to hire thousands of workers to manage it, requiring significant budget increases that already are being targeted by congressional Republicans determined to dismantle the president's signature initiative.

"Knowing the complexity of the health law, there's no question

Treasury spokeswoman Sabrina Siddiqui said, "The overwhelming majority of funds used by the agency to implement the Affordable Care Act go to administer the premium tax credits, which will be a tax cut averaging about $4,000 for more than 20 million middle-class people and families."

The Supreme Court, in its 5-4 ruling, upheld the mandate that most Americans get health insurance. The majority said Congress has the power to enforce the mandate under its taxing authority. The decision labeled the penalties a tax, noting that they will be collected by the IRS.

Those who don't get qualified health insurance will be required to pay the penalty -- or tax -- starting for the 2014 tax year, unless they are exempt because of low income, religious beliefs, or because they are members of American Indian tribes.

The penalty will be fully phased in by 2016, when it will be $695 for each uninsured adult or 2.5 percent of family income, whichever is greater, up to $12,500. The nonpartisan Congressional Budget Office estimates that 4 million people will pay the penalty that year.

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Tax man set to police Americans on health insurance

TRENTON At 61 years old, K Ka had spent most of his life in prison.

His decades behind bars kept him from learning about life on the outside, including matters of mental health. Diagnosed with schizophrenia and suffering from bouts of paranoia, Ka didnt understand what was going wrong with him.

I had a mental illness and I didnt know it, he said. Its like youve got something wrong with you, but you dont know what it is. They say, This is your diagnosis, but you dont know what it is. Youre paranoid. Okay, what does that mean? Youre schizophrenic. Okay, whats that?

As he was approaching his release date three years ago, Ka connected with the counselors of Greater Trenton Behavioral Health Care, an agency that coaches people with histories of serious mental illness to live more independently.

The agencys supportive housing program helps clients to make doctors appointments, attend therapy sessions and track medications. Started in 2006 with just 12 clients, the program is now helping Ka and more than 200 others to gain what might be the greatest of medical benefits a home.

Greater Trenton is working with the two-year-old Trenton Health Team, a collaboration among the city, local hospitals, clinics and social service organizations that is trying to stem the high rates of emergency room visits in the city. What the team and its cohorts are repeatedly finding is that the sickest, most expensive patients are often also homeless.

Closely integrating housing and medical care is a growing trend, said Ruth Perry, executive director of the health team. The Trenton Health Team is working very hard to understand the health needs of our homeless residents, and looks forward to collaborating with our community partners to end the scourge of homelessness so that the homeless residents of Trenton can have better health and a better quality of life.

Greater Trentons supportive housing program helps former inmates, rehabilitated patients from state hospitals and other individuals with serious mental illnesses who are at risk of homelessness.

A NORMAL LIFE

I had been in prison for 35 years of my life, Ka said. This is the longest I have ever been out of prison, since I was like 10 years old.

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Trenton health care program gives a home to former inmates and patients with mental illnesses

Nancy Pelosi Speaker John Boehner Jerrold Nadler

"Today, in upholding the Affordable Care Act, the Supreme Court has shown that, even at a time when Washington seems to have reached a new level of dysfunction, there remains a respect for the rule of law, for precedent, and for the ability of Congress to legislate on matters that affect the American people," Rep. Jerrold Nadler (D-N.Y.) said in a statement. "By not caving in to the most craven political calls, it appears the Court has stood by more than 70 years of legal precedent to ensure that: some 32 million Americans will have access to health insurance; we stop the unnecessary deaths of 42,000 Americans annually who die simply because they lack health insurance; insurers can no longer deny a child health care because of pre-existing conditions; millions of young adults receive coverage on their parents' plans until age 26; insurers can no longer impose lifetime limits on coverage; millions of Americans receive free preventive care; and, seniors save billions of dollars on prescription drugs. "The Affordable Care Act will now assume its rightful place, along with Social Security and Medicare, as powerful testimony to what our nation can achieve to benefit the lives of all Americans. Today's decision will, I truly hope, put to rest the partisan attacks from the Right against the law and many of its provisions. Republicans have threatened to continue their attempts to repeal these provisions, but let us all hope that they will respect the Court's ruling and put the health and wellbeing of the American people ahead of insurance companies."

"Today's decision makes one thing clear: Congress must act to repeal this misguided law," said Sen. Republican Leader Mitch McConnell. "Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire. Today's decision does nothing to diminish the fact that Obamacare's mandates, tax hikes, and Medicare cuts should be repealed and replaced with common sense reforms that lower costs and that the American people actually want. It is my hope that with new leadership in the White House and Senate, we can enact these step-by-step solutions and prevent further damage from this terrible law."

Republican Governors Association Chairman Bob McDonnell issued the following statement regarding the Supreme Court's decision to uphold the Patient Protection and Affordable Care Act: "Today's ruling crystallizes all that's at stake in November's election. The only way to stop Barack Obama's budget-busting health care takeover is by electing a new president. Barack Obama's health care takeover encapsulates his Presidency: Obamacare increases taxes, grows the size of government and puts bureaucrats over patients while doing nothing to improve the economy. It's never been more important that we elect a President who understands the marketplace and will make job creation his top priority. By replacing Barack Obama with Mitt Romney, we will not only stop the federal government's healthcare takeover, but will also take a giant step towards a full economic recovery."

"Dr. Coburn will be reviewing the ruling and will respond with an updated plan to repeal and replace this unworkable law. The Court affirmed Congress' power to tax people if they don't eat their broccoli. Now it's up to the American people to decide whether they will tolerate this obscene abuse of individual liberty," said John Hart, a spokesman for Sen. Coburn.

"Today's Supreme Court decision sets the stakes for the November election. Now, the only way to save the country from ObamaCare's budget-busting government takeover of health care is to elect a new president," said RNC Chairman Reince Priebus. "Under President Obama's signature legislation, health care costs continue to skyrocket, and up to 20 million Americans could lose their employer-based coverage. A panel of unelected bureaucrats now has the unprecedented authority to come between elderly patients and their doctors. Meanwhile, the rules and regulations placed on job creators and small businesses make it nearly impossible to hire new workers at a time when Americans desperately need jobs. "We need market-based solutions that give patients more choice, not less. The answer to rising health care costs is not, and will never be, Big Government. "We must elect a president who understands the economy, respects free enterprise, and can provide the leadership we now so desperately need. On Election Day, we must elect Mitt Romney and put America on the path toward a brighter economic future and successful health care reform."

Today, House Majority Leader Eric Cantor (R-VA) released the following statement on the Supreme Court ruling on the President's health care law: "The Supreme Court's decision to uphold ObamaCare is a crushing blow to patients throughout the country. ObamaCare has failed to keep the President's basic promise of allowing those who like their health care to keep it, while increasing costs and reducing access to quality care for patients. In this tough economy, jobs and economic growth are on the minds of most Americans, but ObamaCare has increased uncertainty for small businessmen and women and forced them to put their hiring decisions on hold. "During the week of July 9th, the House will once again repeal ObamaCare, clearing the way for patient-centered reforms that lower costs and increase choice. We support an approach that offers simpler, more affordable and more accessible health care that allows people to keep the health care that they like. "The Court's decision brings into focus the choice the American people have about the direction of our country. The President and his party believe in massive government intrusions that increase costs and take decisions away from patients. In contrast, Republicans believe in patient-centered, affordable care where health care decisions are made by patients, their families and their doctors, not by the federal government."

House Democratic Whip Steny H. Hoyer (MD) released the following statement today after the Supreme Court's decision on the Affordable Care Act: "Our highest court has weighed in, and its decision to uphold the Patient Protection and Affordable Care Act is a victory for all Americans who have ever worried about being able to access or afford the care they need. Democrats are proud to have worked hard to pass this landmark legislation in 2010 and of our efforts to make sure it is implemented in a way that continues to yield new benefits for patients, employers, and care providers. "The Affordable Care Act made it illegal for insurance companies to discriminate against patients on the basis of pre-existing conditions, allowed young people to remain on their parents' plans until age 26, and prohibited insurance companies from charging women higher premiums than men. The Medicare Part D 'donut hole' is closing, and seniors on Medicare now have access to free preventive services like mammograms and colonoscopies. Moreover, the Affordable Care Act provides deficit savings of more than $1 trillion over the next two decades. The Affordable Care Act further brought peace of mind to the 30 million uninsured Americans who will finally be able to access affordable coverage once the law is fully implemented. "Republicans have been trying to repeal the Affordable Care Act since the day it was enacted, and they have been eagerly awaiting today's ruling. But they must now accept that the Affordable Care Act will remain in place and that the time for litigation and partisan posturing on this issue ought to come to an end. Republicans now have a responsibility to work with Democrats to implement the Affordable Care Act, and I call on them to do so in order to make care affordable and accessible to Americans."

Following the Supreme Court's decision affirming the constitutionality of the Affordable Care Act, former Governor and U.S. Senate candidate Tim Kaine today released the following statement: "The Affordable Care Act is an important first step in curbing discriminatory insurance company practices and increasing access to health care, but more needs to be done to bring down costs. Our government, businesses, and citizens cannot continue to spend more than any other nation on health care while getting second-rate results. As Senator, I am committed to working with all stakeholders to find additional improvements to the Affordable Care Act that give all Americans affordable access to high quality services. "While there is more work to do, it is worth noting what has already been accomplished under the Affordable Care Act. Nearly 63,000 more young people in Virginia have health coverage, more than 800,000 Virginia seniors have received free preventive care, millions of small businesses are now eligible for tax credits, and twenty million American women have access to cancer screenings and contraception without co-pays. And we've put an end to the egregious abuses by insurance companies that denied coverage to children with preexisting conditions, charged women higher premiums for the same coverage, and dropped folks when they got sick. "My opponent regularly calls for a full repeal of this law, despite the positive results it's already delivering for Virginia. In the decade encompassing George Allen's six years as a U.S. Senator, the average insurance premium for families more than doubled and over 12 million more Americans were uninsured. Clearly, inaction was not a solution, and neither are continued calls for repeal. Instead we must work together to strengthen this existing program and improve cost controls."

"In passing health reform, we made history for our nation and progress for the American people. We completed the unfinished business of our society and strengthened the character of our country. We ensured health care would be a right for all, not a privilege for the few. Today, the Supreme Court affirmed our progress and protected that right, securing a future of health and economic security for the middle class and for every American."

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John Roberts Health Care Switch Sparks 'Deep' Supreme Court 'Discord': CBS News (VIDEO)

July 8, 2012

By STEPHEN OHLEMACHER, Associated Press

WASHINGTON (AP) -- The Supreme Court's decision to uphold most of President Barack Obama's health care law will come home to roost for most taxpayers in about two-and-a-half years, when they'll have to start providing proof on their tax returns that they have health insurance.

That scenario puts the Internal Revenue Service at the center of the debate, renewing questions about whether the agency is capable of policing the health care decisions of millions of people in the United States while also collecting the taxes needed to run the federal government.

Under the law, the IRS will provide tax breaks and incentives to help pay for health insurance and impose penalties on some people who don't buy coverage and on some businesses that don't offer it to employees.

The changes will require new regulations, forms and publications, new computer programs and a big new outreach program to explain it all to taxpayers and tax professionals. Businesses that don't claim an exemption will have to prove they offer health insurance to employees.

The health care law "includes the largest set of tax law changes in more than 20 years," according to the Treasury inspector general who oversees the IRS. The agency will have to hire thousands of workers to manage it, requiring significant budget increases that already are being targeted by congressional Republicans determined to dismantle the president's signature initiative.

"Knowing the complexity of the health law, there's no question that the IRS is going to struggle with this," said Rep. Charles Boustany Jr., R-La., chairman of the House Ways and Means oversight subcommittee. "The IRS wants more resources. Well, we need to start digging down into what are they doing with the resources and personnel."

Treasury spokeswoman Sabrina Siddiqui said, "The overwhelming majority of funds used by the agency to implement the Affordable Care Act go to administer the premium tax credits, which will be a tax cut averaging about $4,000 for more than 20 million middle-class people and families."

The Supreme Court, in its 5-4 ruling, upheld the mandate that most Americans get health insurance. The majority said Congress has the power to enforce the mandate under its taxing authority. The decision labeled the penalties a tax, noting that they will be collected by the IRS.

More:

On health care: The tax man cometh

Health care reform will kill jobs in the United States. Or it will save taxpayers $1.3 trillion.

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Fact Checker: Needless falsehood on both sides of health debate