Obamacare is a tax that is costly to businesses and individuals in a lot of obvious ways. Many of those, though – the penalties, the fees, the increased costs of coverage, the loss of doctors and health plans – have already been covered ad nauseam. One aspect of the law’s cost to the American economy that has received comparatively little attention has been the compliance costs imposed on the healthcare sector by the law. And last week, those costs got much worse.

One of the most pernicious ways in which the Federal Government taxes businesses is by requiring them to prepare and turn in reams of paperwork that probably no one will ever read in order to comply with regulations that were neither passed nor approved by Congress. In addition to the absolute material/shipping costs associated with complying with these regulations, there are also the costs associated with paying employees for the time required to comply with these requirements. Businesses  – which are overwhelmingly small businesses in this particular field – lay out money that is completely uncompensated by the government just for the privilege of jumping through these hoops.

The healthcare field already has a lot of hoops to jump through, in terms of compliance with federal regulations. And the regulations passed by HHS and the Treasury department last week in connection with Obamacare just added to those hoops in both a kind and quantity that are sui generis, even within the rubric of healthcare legislation. And the end result of this may be negatively impacted patient care:

Now four years old, ObamaCare imposes 159 million hours of paperwork a year on the public. That’s the administration’s own estimate, undoubtedly a lowball.

Even so, it’s up by 48 million hours over last year, when fewer regulations had been rolled out. And there’s more to come.

Among the July 3 rules is one that compels doctors who take Medicare to report 18 different clinical measurements on their patients, such as whether they are overweight and have been counseled about weight control.

Doctors who fail to do it will get whacked with lower payments starting in 2015.

The regulators estimate that this single report could take as long as 108 minutes per patient and consume 5.4 million hours a year nationwide. That’s time that could be spent treating patients or calling them to remind them to take their meds.

Unfortunately, it isn’t just healthcare companies that are going to be hit with these additional paperwork costs. Restaurant owners will have to spend massive hours complying with nutrition labeling requirements imposed by Obamacare. All employers will be required by Treasury to fill out and process additional questionnaires by each employee or contractor they hire to essentially prove that they are not attempting to get around the employer mandates. And as employers struggle in a continually sluggish economy to make ends meet, they will have to face the choice of either more labor outlay which will return no corresponding additional revenue, or less time spent creating the goods and services that are their reason for existing in the first place.

Unfortunately for us, the worst of Obamacare’s taxation is far from over; it hasn’t even hit yet.