Health Law "Taxes" the IRS

by U.S. Senator Chuck Grassley

The highest court in the land issued a landmark decision just days before the United States celebrated its 236th anniversary declaring independence from a tax-happy monarchy.  I respect the Supreme Court, but the colonial patriots who rallied against "taxation without representation" and blazed the trail for liberty, freedom and the pursuit of happiness must have rolled over in their graves on the eve of Independence Day 2012.

The 5-4 ruling upholding the 2010 health care law essentially gives Congress a license to use its taxing authority to regulate and direct the public in infinite scenarios as a means to an end.  Writing for the majority, Chief Justice Roberts threaded a legal needle, massaging the federal law to solve a Constitutional conundrum.

As the Chief Justice wrote in his 59-page opinion, "...the requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax."  Using this logic and Congress' track record for inflating the tax code, it is undoubtedly reasonable that the long arm of the law will be reaching deeper into the public's pocketbooks to steer and regulate citizens' behavior.

Notwithstanding the considerable issues of individual liberty, freedom of religion and free enterprise, the ruling triggers all kinds of administrative nightmares.  By any measure, the Internal Revenue Service already has its hands full administering an exceedingly complex federal tax code.

The IRS handles over 145 million individual tax returns annually and its workforce is under increasing pressure to thwart identity theft, close the tax gap, and balance customer service with efforts to track down tax cheats.

The IRS has enough on its plate to properly and effectively carry out its primary mission:  enforcement of the nation's revenue laws.  That's why during Senate debate on the health care law I raised concerns about giving the IRS more responsibility than it could chew.

Just consider a recent report that reveals a surge in identity theft (450,000 cases) and high-dollar refundable credits fraud.  The IRS faced unprecedented backlogs during the past tax season as the agency worked to keep up with the jump in fraudulent schemes.  Its fraud detection system identified more than one million returns as potentially fraudulent.

As a member of the tax-writing Senate Finance Committee, I have worked to try to make the IRS an accountable tax collection agency.  From championing taxpayer service to strengthening transparency through my advocacy of whistleblowers and the independent taxpayer advocate, I have worked through legislative and oversight channels to help the IRS better do its job for the honest taxpaying public.  The big spenders in Washington tirelessly seek to increase the IRS budget, angling for billion dollar increases.  The tiresome argument undoubtedly will be re-charged now that the IRS has been charged with administering a slew of new tax laws included in the 2010 health care law, including the individual health insurance mandate, the employer free-rider penalty, the premium subsidy for low-income individuals and the small business tax credits.

Consider the "unprecedented" backlog this tax season as just the tip of the iceberg.  Imagine the dysfunction once the IRS starts to sort through millions of returns claiming refundable insurance premium tax credits, verifying income information for the new government insurance exchanges, calculating and collecting excise taxes and assessing the individual mandate tax.

Speaking from three decades of experience as a taxpayer watchdog, my crusade to root out waste, fraud and abuse tells me the IRS hasn't seen anything yet.

Assigning the administration of social welfare programs to IRS is misguided policy.  Unless, of course, centralizing health care, growing new layers of government and putting federal bureaucrats in charge of one-fifth of the nation's economy are underlying goals of 2010 health care law.  The partisan overhaul was an overreach that missed an opportunity to enact important reforms to the health care system that have broad-based support.

The IRS certainly has its work cut out to try and connect the dots and collect the mandate "tax," distribute premium subsidies, administer health insurance coverage and keep on top of its core mission of collecting taxes.

Voters who disagree with the Supreme Court's ruling need to take Justice Roberts' advice. He noted the nine justices on the court "possess neither the expertise nor the prerogative to make policy judgments.  Those decisions are entrusted to our Nation's elected leaders, who can be thrown out of office if the people disagree with them.  It is not our job to protect the people from the consequences of their political choices."

Justice Roberts essentially pitched the ball back to the court of public opinion for the electorate to decide in November if the Supreme Court hit a home run or struck out by upholding the health care law.

There wasn't a name for the syndrome before the 1960s, when psychologists started recognizing a condition among patients who all happened to be Holocaust survivors. It came to be known as "survivor guilt."

The affliction also affects those who have endured war, natural disasters, the suicide of a loved one, epidemics and even employment layoffs. Eli Nussbaum, recently named among the top pediatric pulmonologists, is keenly aware of the circumstances surrounding this subset of post-traumatic stress disorder.

"I am a consequence of the Holocaust - both of my parents lost their families during those years," says Nussbaum, author of The Promise (www.elinussbaum.com), a novel that begins in Poland on the eve of World War II and follows three generations through the aftermath.

He is among the group known as the "Second Generation" - children born to survivors anxiously trying to rebuild the families they'd lost. Nussbaum was born in Poland to a man who'd lost his first wife and four children, and a woman who lost her first husband and child, during the Nazi's genocidal regime.

"Because of my family background, I am intimately aware of life's fragility and how a devastating experience can affect a person emotionally," he says. "As a Second Generation, I too was shaped by my parents' trauma. While being raised by survivors made some of us more resilient and better able to adapt and cope, it made others distrustful of outsiders and always on the defense."

For anyone profoundly affected by loss, he says, it's worth the effort to work at transitioning from guilt to appreciation of the gift that is their life. He offers these tips:

• Seek treatment early: The sooner counseling is provided, the more preventable or manageable guilt may be. Early methods may recognize a survivor's feelings and eventually offer alternative perspectives. The hope is to get the survivor to see the loss of colleagues, friends or family as the result of misfortune that has nothing to do with personal culpability.  

• Watch for delayed reactions - even years later: No two individuals are identical, and some survivors do not show symptoms until long after a traumatic event. If you or a loved one has experienced a life-altering change or loss and later develop problems such as clinical depression or a prevalent sense of self-blame, be aware they may be rooted in past trauma and share that information with a counselor. Other problems that could be signs of survivor guilt: nightmares, unpredictable emotional response and anxiety.

• Don't turn to drugs or alcohol to cope with uncomfortable feelings: Many people suffering post-traumatic stress-related disorders try to self-medicate or somehow will themselves into a better mental state. Drug addiction is often the result, which is why those who suspect a problem should seek professional help. One-on-one therapy, as well as group talk and possibly doctor-prescribed medications are frequently used to help survivors move past guilt.

"Whether people are dealing with the loss of life from combat, or an accident, or suicide, they may not consider themselves 'victims.' So they don't seek help," Nussbaum says. "They may also feel that no one has been through the same experience.

"That's why it is important to be surrounded by loved ones who can offer love, support and perhaps the perspective to seek professional help."

Because their families were gone, many Holocaust survivors did not have that option, which Nussbaum says made the writing of his novel that much more imperative.

"Only they can know just what it was like - but suffering is a universal experience to which we can all relate," he says. "Life can get better, and the story of my parents, and the fortune in my life, is proof of that."

About Eliezer Nussbaum, M.D.

Eliezer Nussbaum, M.D., was born in Katowice, Poland. He is a professor of Clinical Pediatrics Step VII at the University of California and Chief of Pediatric Pulmonary Medicine and Medical Director of Pediatric Pulmonary and Cystic Fibrosis Center at Memorial Miller Children's Hospital of Long Beach. He has authored two novels, three non-fiction books and more than 150 scientific publications, and was named among the top U.S. doctors by US News and World Report in 2011-12.

AmeriCorps service program benefits include living stipend and education benefit of $5,500

DECORAH, Iowa -- The Northeast Iowa Food & Fitness Initiative has openings for four School Outreach Wellness program volunteers starting Sept. 1.

An AmeriCorps Volunteer position, these School Outreach Wellness members of the Northeast Iowa Food & Fitness Initiative team will receive a living allowance stipend and an additional $5,500 educational award at the end of their service.

For information and applications, contact Emily Neal, director of School Outreach at Luther College, e-mail nealem01@luther.edu, telephone (563) 387-2138, postal address Luther College, Attn: Emily Neal, 700 College Drive, Decorah, IA  52101.

Successful candidates will demonstrate ability to work with others, good communication skills, and experience working with young people. Post-secondary degree preferred.

Review of applications begins July 20, 2012.

The four successful candidates will join a team of enthusiastic folks working in more than 20 schools throughout northeast Iowa to promote local food and physical activity.  They will receive training to serve as a resource for school wellness committees in three regional school districts.

School Outreach Wellness members strengthen relationships with schools and communities regarding wellness for area youth.

Volunteers will sometimes serve as teachers or presenters and at other times train others to be teachers and leaders.  They will help organize school-community events that showcase Farm-to-School and Safe Routes to School programs, develop community partnerships and build healthy families.

Projects can include starting or maintaining school gardens in many communities and instructing students, teachers and staff about the benefits of growing and consuming healthful food. Volunteers work from an office in Luther College Environmental Studies department with desk, computer and phone to facilitate connections with other organizations and people doing similar service.

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House Vote to Repeal the Affordable Care Act = Politics as Usual

"We are in this fight to keep Medicare benefits from being stripped away from millions of seniors by Members of Congress who vote to repeal the Affordable Care Act. The ACA will save lives, it will provide coverage to millions who lack insurance and it already provides improved benefits for less cost to seniors in Medicare. America's health and economic security should take priority over election-year politics; however, this vote proves once again, politics trumps policy in the House.  The Affordable Care Act is law, it's working, and it's long past time for Congress to start making economic growth a priority." Max Richtman, President/CEO

While political rhetoric dominated much of today's House repeal debate, the facts about the benefits provided to seniors in Medicare -- which would be lost if health care reform was repealed -- were largely ignored.  Here are just a few of the benefits that would be lost if the Affordable Care Act was repealed.

*  The typical senior would lose $4,200 over the next decade in prescription drug savings provided in the ACA

*  The Part D coverage gap known as the 'donut hole' would return

*   Annual wellness visits for beneficiaries would no longer be covered by Medicare

*   Seniors will now pay more for preventive services. Medicare would no longer fully cover

screenings like mammograms, pap smears, bone mass measurements, depression screening,

diabetes screening, HIV screening and obesity screenings

*   Almost 3.3 million uninsured Americans ages 50-64 who would have been insured under

Medicaid will remain uninsured

*   The Medicare Trust Fund's solvency would be shortened by 8 years

A full analysis of the Medicare and Medicaid improvements that were preserved as a result of the recent Supreme Court ruling to uphold the Affordable Care Act can be found on the National Committee's website.

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The National Committee, a nonprofit, nonpartisan organization acts in the interests of its membership through advocacy, education, services, grassroots efforts and the leadership of the Board of Directors and professional staff. The work of the National Committee is directed toward developing better-informed citizens and voters.