The clock is ticking, but like Alice we cannot see what lies at the end of the rabbit hole. With pending elections, expiring tax provisions, exploding debt and a weak economy, the only certainty is that no one knows what the final tax structure will look like in 2013.

President Obama’s federal health care law requires almost everyone to be insured and ensures coverage be made available to those if they are already ill or need expensive care. The ruling clears the way for a large restructuring of the health care system and affects virtually every American. How will health care reform be paid? It will be financed in large part by tax increases on the “wealthy”.

Here is a look at some of the tax provisions in the health care law and some things to think about with respect to tax planning:

Is it déjà vu and will 2012 be a repeat of 2010? It was less than two years ago when the United States Congress, faced with an election year and a pre-mandated reversion of the tax laws to those in place in 2001, “kicked the can” down the road and extended the Bush tax cuts to 2013. In the process of avoiding the politics associated with meaningful tax reform, Congress actually temporarily made more favorable the estate tax laws with the caveat that these also would be subject to the 2013 sunset reversion.

I usually advise investors to wait until yearend before making any tax motivated decisions regarding capital gain or loss recognition. Tax law changes at the end of the year could affect the rates for the current and/or subsequent years. Also, capital gains and losses could be dramatically affected by market forces during the year. These factors become clearer as yearend approaches. This year may be different. Potentially significant changes in the tax rate on capital gains after 2012 suggest a more proactive capital gains strategy starting now.