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The IRS will be responsible for enforcing insurance provisions of the Health Bill: IRS Faces Tough New Duties Under Health Overhaul : NPR As US tax treaties are revised to provide for greater assistance in collection (the US-Canada treaty provides for reciprocal collection of tax from noncitizens of the requested State) the risk to expats increases.

Up to now it has been dual US-Israeli nationals in Israel who have been fighting this issue: Shiloh Musings: Re: Obama's Health Bill, What About The Expats? Will We Be Fined?

Until and unless the Bill is revised or tax treaties amended, expat Americans (and green-card holders) could be "fined" from $95 to $1900 even though they have valid and collectible insurance or health cover abroad.

Medicare will count as "insurance"; but aside from that Amcits may be forced to buy useless cover, or pay a penalty. Perhaps some insurer (AIG anyone?) will come up with a policy that is guaranteed to pay out nothing but meets the requirements of the law.
 

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I wouldn't get too worried about this just yet. There are still at least two different "health care bills" - one from the Senate and the other from the House - that have to be "reconciled" before we'll know what effect, if any, there will be on US expats.

Personally, I ain't buying any additional coverage. If you have to provide a form or letter from your provider, there is usually something you can get from the national health care system wherever you are that attests to the fact you're covered. In France, you can request an attestation of your coverage from the Ameli site. It's a standard document that is produced for any number of reasons here in France. So what if it's all in French - that's their problem. I'm sure the British expats can request one of those many E forms they use for holidays on the Continent.

Sometimes you have to get a little bit creative with the IRS. But first let's see exactly what gets passed into law before we panic. If they give the IRS the enforcement responsibility, chances are, it will be subject to IRS developed regulations and not hard-coded into the law.
Cheers,
Bev
 
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