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Bill Radke: Well, Congress has enacted the historic health care overhaul. Now comes the hard part: enforcing it. From our health desk at WHYY in Philadelphia, Marketplace's Gregory Warner has that.

Gregory Warner: For the last three years, Alan Cohen has had to file an extra form with his Massachusetts state tax return. To prove:

Alan Cohen: That we have purchased insurance, or at least we have employer-sponsored coverage of some type.

Cohen directs the Boston University Health Policy Institute. Massachusetts requires residents to have insurance coverage. With the new health care reform bill, when the federal mandate to buy insurance takes effect in 2014, the IRS will be enforcing it.

State commissions will be in charge of making sure insurance companies conform to the new law. Tom Dehner is a health care consultant and former state Medicaid director. He says if insurance companies don't comply, states can bar them from participating in the sure-to-be lucrative exchanges, where they sell insurance to individuals and small businesses.

TOM DEHNER: Yeah. So if you're an insurance plan, you want to be part of the insurance exchange. And you're going to make the changes in your practice and your policies to make sure that that happens.

Proving that every stick needs a carrot as well.

In Philadelphia, I'm Gregory Warner for Marketplace.

Follow Gregory Warner at @radiogrego