Now that health reform has been upheld... A series of tax hikes are poised to take effect. The Supreme Court has decided that the provision in the law requiring people without health coverage to either buy insurance or pay a fine is constitutional under Congress' power to impose taxes. Republicans are vowing to repeal the entire health reform law, but they'll need to retake the White House and Senate and retain the House this November to have any shot at nixing the law.That's far from certain right now.

A Batch of reform-related tax increases are going into effect in 2013. Upper-income earners will pay more in Medicare taxes. A 0.9% surtax on singles with wages exceeding $200,00 and couples earning over $250,000 kicks in. This applies only to the employee's share. The surtax also hits the self-employed.

Unearned income will be subject to 3.8% Medicare surtax. for singles with modified adjusted gross incomes over $200,000 and marrieds over $250,000. Modified AGI plus tax free foreign earned income. The levy applies to the lesser of the filer's net investment income or the excess of modified AGI over the thresholds. Investment income includes interest, dividends, capital gains, annuities, royalties and passive rental income, but no tax free interest or payouts from retirement plans.

The 7.5%-of-AGI floor for deducting medical expenses will jump to 10% for filers under age 65. This tightening won't apply to those 65 and older until 2017.

Pays to health flexible spending accounts will be capped at $2,500 a year. The federally subsized part of retiree drug plan costs will be nondeductible. And a 2.3% excise tax on medical devices takes effect. Items commonly sold at retail, such as glasses, contact lenses and hearing aids, are exempt from the tax.

Starting in 2014, individuals who remain uninsured will owe a penalty tax equal to the larger of $95 or 1% of income above the filing threshold... the income level that triggers the requirement to file. For families, the penalty will be capped at $ 285. The charge then rises sharply the next two years. In 2016, the top fine will be $2,085. Lower- and middle-incomers will get an income tax credit to help them afford coverage.

Firms with 50 or more full-timers but no health plan will owe an excise tax if even one employee gets the credit. The tax is $2,000 times the number of employees, with 30-employee offset. It's also due if an employer offers health insurance coverage that is substandard or is too costly for employees. If any employee buys coverage through exchange, the tax rate rises to $3,000. Employers cannot deduct the tax. And insurers will pay a fee... $8 billion in 2014, rising to 14.3 billion by 2018.

In 2018, insurance firms and self-insurers with " Cadillac" plans are hit with 40% tax on the cost of plans in excess of $10,200 for individual coverage and $27,500 for family plans in most cases, with a potential inflation adjustment.

The net result: IRS' role in health reform is only going to get larger.