The Breck Girl's plan is (unsurprisingly) really simple: when you send in your taxes, you also get to send in a form from your insurance company which states that you and any dependents are covered. If you don't the IRS notifies your local health care agency - a brand-new bureaucracy - and they will decide what sort of coverage you should have. They'll then enroll you in a plan, and bill you for monthly payments. What happens if you don't make the payments? Well, then the federal government garnishes your wages for back premiums, plus interest, plus any collection costs. In view of the fact that if the feds or the state owe you a tax refund, they pay you no interest on the overpayment, the garnishment part of the plan is a really special touch.