"One has to believe it was no accident that the Tax Code amendment [adding section 1411 to the Internal Revenue Code] is buried deep within and close to the end of the nearly 3,000-page two-part legislative package. Doubtless only a relatively few who read the ACA before (or even after) its enactment got as far as section 1402 of HCRA; and, of those few, even fewer were searching for new tax legislation in that section or recognized the enormous impact of Section 1411 as an income tax rather than the payroll tax that its 'Medicare' title connoted.... But it is not clear how that strategy will play out in the Supreme Court when, as seems likely, a case testing the tax standing of Section 1411 appears on the Court's docket."

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