What do you get when you cross health care with the IRS? Something very scary. William Jacobson of Legal Insurrection explains that the IRS will getting reports of who has health care coverage, and enforcing taxes as part of the deal in both House and Senate versions.

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.