That's why it's a tax bill. Calling it a healthcare bill is a straight-out lie. It's a tax bill that slaps civil and criminal penalties for either 1) not purchasing a health insurance policy from an IRS-approved health insurance provider, or 2) paying an increased tax rate.
And it applies only to people who have been presumed by the IRS to be liable to it's strict, detailed provisions.
And the courts have repeatedly ruled that 1) neither the courts nor the IRS have to explain nor prove their presumption of any application of tax law, and 2) if there is a legal way that they know of that you can show you are exempt, they don't have to tell you about it.
Which means that everyone might well be exempt from this entire healthcare tax bill, and the courts and the governement may well know it, but they don't have to tell you about it. And that if you don't figure it out yourself, and figure out how to present it to them in a way they have to acknowledge, they can come after you anyway, even knowing you are exempt.
While there are tax increases involved in this bill as well, the portion that is particularly unconstitutional is the requirement to purchase insurance from private companies. Purchasing a service or good from a private company is in no way a tax, nor can it be compelled. If that were true, why bother to pass a cash for clunkers bill, why not just require all Americans to buy a new car? That is in essence what the democrats are doing here, forcing purchase of a good or service under penalty of fines and jail.