The health-care bill, which is President Obama’s top domestic priority, would extend insurance to about 30 million people who now lack it, expand the reach of Medicaid for the poor, and impose new rules on health insurance companies. It would cost about $871 billion over 10 years, but raise more than that in new taxes and fees and cuts in Medicare. Democrats win the vote 60-39 over Republican objections.With the economy struggling to break the chains of a job-destroying recession. Under Obama-care, Americans will be forced to buy government-approved health insurance and anyone earning a middle class wage will have to pay for it out of their own pocket. Federal subsidies will only be provided for people who are not offered coverage by their employer and earn below the 400 percent poverty level. Families whose employers drop their plan will be forced to buy it on their own – at a cost of over $15,000 dollars a year. “The Senate health care bill gives employers two powerful incentives to stop offering health insurance coverage to their workers,” writes Terry Jeffrey“First, if an employer does offer coverage, its lower-wage workers will lose the federal insurance subsidy they would otherwise get.Secondly, if an employer does not offer coverage, the $750-per-worker fine it faces will be far less than the premiums it would pay if it did offer coverage.”Families struggling in this deep recession who earn a combined total greater than $88,200 and don’t have their health care covered by their employer will be hit with a mandatory annual fee of about $15,000 according to the Congressional Budget Office’s analysis of the final Senate health-care bill.There is nothing voluntary about Obama’s health-care mandate:The Senate has dismissed concerns over the individual insurance mandate and the tax penalty imposed on those who don’t meet that requirement. If you refuse to pay the penalty or you refuse to provide any information on your health-care status on your tax return, you will face the prospect of being audited by the Internal Revenue Service. This is supposedly a “voluntary mandate” and the IRS can’t do anything against you if you refuse to pay the penalty. They claim that because page 340 (A) and (B) of the bill waives criminal prosecution of taxpayers and says that no liens or levies can be filed on the taxpayer’s property. That claim is wrong.Congressional Budget Office’s (CBO) itself made clear that the financing of health-care reform is based in substantial part on generating $167 billion in “penalty payments” from individual taxpayers and employers.The IRS, which is known for its habit of disregarding court decisions that disagree with its interpretations of the law, may use audits and the ability to find problems in a taxpayer’s finances in areas totally unrelated to the health care mandate to force compliance with the mandate and coerce payment of the tax penalty imposed by Reid’s bill. according to The Heritage Foundation, The very idea of using the taxing powers of the state to force compliance with this law is one that should shock the conscience of everyone, even those who support “reforming” our health care system.Obama’s answer to the question posed by George Stephanopoulosin an interview,  “Under this mandate, the government is forcing people to spend money [to buy insurance], fining you if you don’t. How is that not a tax?’’“George,’’ chided Obama, “the fact that you looked up Merriam’s Dictionary . . . indicates to me that you’re stretching a little bit right now.’’Merriam-Webster’s definition of “tax’’ – “a charge, usually of money, imposed by authority on persons or property for public purposes.’’One place to look to see what the universal coverage would do is the state of Massachusetts, about 200,000 state taxpayers remained uninsured in the beginning year of 2008, it hasn’t made insurance more affordable, Massachusetts has the highest health insurance premiums in the nation. It rose by 7.4 percent in 2007, 8-12 percent in 2008 and will expect to rise 9 percent this year who knows what 2010 will bring, according to Jeff Jacoby who’s article entitled Mandatory insurance: Yes, it’s a tax, addresses the promise Obama’s made not to raise taxes on any American family earning less than $230,000 a year, contradicts that by supporting legislation that would force every American to carry health insurance or pay a hefty penalty to the IRS.Some of the taxes that will be imposed on the public under the new health-care bill that has people taken back with concern: according to H.R. 3590 Patient Protection and Affordable Care Act.Section 1501 – Requirement to maintain minimum essential coverage – Individuals will be required to maintain health insurance. Those that do not will be assessed an annual tax penalty of $750. The tax penalty is scheduled to escalate in subsequent years. Consequently, Massachusetts residents that do not maintain health insurance will be assessed a tax at both the state and federal level.Section 9001 – Excise tax on high cost employer-sponsored health coverage – This provision levies an excise tax of 40 percent for any health coverage plan that is costs over $8,500 per year for single coverage and $23,000 per year for family coverage. Since this was protested vigorously by unions and public employees, the Senate caved and granted a massive concession. The tax is not levied on the individual receiving the tax free benefit, but is levied on the insurance company or plan administrators that provide the employee the benefit. How absurd is that?Section 9008 – Imposition of annual fee on branded prescription pharmaceutical manufacturers and importers – This piece of the legislation imposes a $2.3 billion excise tax on the pharmaceutical industry. The tax is allocated across the industry and is based on market share, not on income. This tax starts immediately and is non-deductible for the corporation being taxed. These companies will still be required to pay their federal income taxes.Section 9009 – Imposition of annual fee on medical device manufacturers and importers – This section imposes a $2 billion excise tax on the medical device industry. The fee is allocated across the industry based on market share, not on income. This tax starts immediately and is non-deductible for the corporation being taxed.Section 9010 – Imposition of annual fee on health insurance providers – Another excise tax. This one is assessed on the health insurance industry in the amount of $6.7 billion taxed out and is also based on market share. How can the imposition of $11 billion in excise taxes (section 9008, 9009 and 9010) on the health care industry reduce costs to consumers? Does anyone else suspect these companies will have to pass these costs over to consumers?Section 9013 – Modification of itemized deduction for medical expenses – For those incurring significant medical costs, your ability to deduct these expenses will be decreased. This legislation increases the adjusted gross income threshold for claiming an itemized deduction from 7.5 percent to 10 percent.Section 9015 – Additional hospital insurance tax on high-income taxpayers – This increases the Medicare tax on wages by 0.50 percent on individuals making in excess of $200,000 and married couples making over $250,000. This will be effective starting January 1, 2013. (As a side note, individual income taxes are already scheduled to increase in 2011, with the highest rate already increasing by 4.6 percent. This will be in addition to the tax increase as outlined here in Section 9015.)”Average premiums per policy in the non-group market in 2016 would be roughly $5,800 for single policies and $15,200 for family policies under the proposal,” according to the Congressional Budget Office’s (CBO).