For some U.S. citizens, the Trump administration’s 2017 tax cuts provided an economic boost. But for Carrie, a 50-year-old doctor living in Amsterdam, they have added to a slow-moving financial disaster that threatens a six-figure debt.

Carrie says that when she finally explained her circumstances to an accountant earlier this year, she heard panic in the professional’s voice.

“He said: ‘This is bad. This is bad.’ He kept repeating it,” Carrie said.

Carrie is now expecting to be hit not only by an Obama-era tax change that is compelling thousands of U.S. citizens around the world to file taxes for the first time but also by another, more complicated and less-noticed change made during the Trump administration.

And although that change was made with U.S. corporations in mind, foreign individuals like her may feel the hardest impact.

Her accountant currently estimates a U.S. tax bill of at least $107,000 — a sum that Carrie fears would wipe out much of the savings designed to send her children to college.

To her, it feels surreal. “I’m not American,” she added. “Well, by your rules I am. But it doesn’t feel like that.”

Carrie, who asked that her full name not be used as she is still in the process of coming into compliance with U.S. tax law, is one of thousands of U.S. citizens who live abroad who have found themselves entangled in U.S. tax laws in recent years. Her accountant issued a statement that confirmed the current estimates of her tax bill.

Like many, her citizenship is an accident of birth — she was born in the United States when her Dutch parents were living there during a six-month sabbatical from work. Her parents were not U.S. citizens. Neither were her siblings.

Although she did apply for a U.S. passport when she was 18, it is long expired, never used.

Foreign governments are starting to take notice of the situation, but they have little leverage to lobby on behalf of their own citizens. The laws that target people like Carrie are designed to target U.S. citizens — whether those people are also foreign citizens or not.

Some countries have sent high-level delegations to push the United States on the issue. Menno Snel, the Dutch state secretary for finance, was in Washington last month to meet members of Congress and officials from the Treasury Department and Internal Revenue Service.

Snel has built an ambitious agenda at home for trying to change the Dutch reputation as a tax haven. He is now trying to protect Dutch citizens from becoming collateral damage in a U.S. battle against evasion.

“Most countries in the world have a different system,” Snel said of the United States in an interview.

The United States is one of only two countries in the world that bases its taxation policies on citizenship rather than residence, according to the Tax Foundation; the other is Eritrea. The U.S. practice is a relic of the Civil War and the Revenue Act of 1862, which sought to punish men who fled to avoid joining the Union army.

Recent changes to the U.S. tax system have increased its global impact. In 2010, the United States passed the Foreign Account Tax Compliance Act (FATCA), which requires all non-U.S. foreign financial institutions to search their records for U.S. citizens and permanent residents and report them to the Treasury.

FATCA was designed to catch tax evaders; in theory, tax treaties exempt anyone from paying U.S. taxes if they have already paid them in the country in which they live. Many do not have enough assets to be required to report them in the U.S. and the IRS can offer an exclusion for roughly $100,000 of income.

Snel said that bilateral tax treaties designed to prevent double taxation and a $50,000 threshold on what has to be reported under FATCA meant that 90 percent of those targeted don’t pay additional taxes.

“There’s just a lot of fuss and rules and bureaucracy,” he said.

But when the sums are bigger, or the tax systems don’t align, it can cause costly and sometimes high-profile problems.

Boris Johnson, the former British foreign secretary who was born in the United States, renounced his U.S. citizenship in 2017 after paying a hefty capital gains tax on a home in London on which he had already paid British property tax.

Foreign institutions have until the end of the end of this year to become fully compliant with FATCA. Activists say that banks have already refused bank accounts and loans to potential U.S. citizens for fear of fines from the U.S. Treasury.

“We all keep quiet because we’re scared,” Carrie said.

To come into compliance with U.S. tax laws, dual nationals may have to deal with mundane but complex aspects of U.S. bureaucracy — acquiring a Social Security number as a nonresident, for example.

“Someone who was not brought up in the U.S., often doesn’t even speak English well, has to go to a U.S.-based tax adviser,” said Daan Durlacher, the Dutch American founder of the group Americans Overseas, adding that legal fees add up to thousands of dollars.

Although she was already facing costs due to the Obama-era FATCA, Carrie’s problem has been made far more complicated and expensive by Trump’s tax cuts — signed into law in the Tax Cuts and Jobs Act of 2017.

That law allowed a one-time tax on assets that U.S.-controlled businesses have accumulated overseas, whether or not they repatriate them to the United States.

The aim was to persuade major American firms to bring assets back to the United States, but it was indiscriminate, requiring huge businesses like Google and small entrepreneurs alike to announce and pay tax on money they had accumulated over decades.

“It offered benefits, exemptions and the application of foreign tax credits to corporations,” said Richard Barjon, the U.S. Individual Tax Practice leader at PwC Switzerland. He added that individuals did not qualify for the same deductions and usually did not have the cash on hand to settle quickly, although the law does provide the possibility of paying in installments.

“It's not favorable at all for individuals,” said Eric Toder, co-director of the Tax Policy Center at the Urban Institute. “Had they thought about it, they probably would have thought of some clause to prevent this from happening."

The issue is particularly acute in countries such as the Netherlands, where the health-care system encourages doctors and other health-care workers to register private limited companies to charge for their services to different hospitals.

Carrie, a medical specialist, had set up three separate private companies and kept her profits in them as a form of savings, which made her circumstances particularly complicated. She estimates that she will spent tens of thousands of dollars just in fees to lawyers and accountants aside from her tax bill.

Other health-care workers are running into the problem, too. Last year, a Dutch TV show interviewed a dentist, also born in the United States, who said he expected to potentially have to pay tens of thousands of dollars in U.S. taxes under the transition tax.

U.S. citizenship had become “a nightmare” in recent years, the dentist, Jan Willem Vaartjes, said.

If it were a different country making these complicated requests, foreign governments like the Netherlands might just ignore them. Two members of French Parliament said in May that the country should consider pulling out of its tax treaty with Washington if more is not done to help French citizens.

But the United States is an economic behemoth, and most countries already have binding tax treaties in place. Speaking in Washington, Snel said he was advocating for a less drastic approach.

“Let’s put our minds and heads together to find a solution,” Snel said in May.

A spokeswoman for the Ministry of Finance, speaking on background in accordance with government practice, said that contact with the IRS has intensified since Snel’s visit but that there were “no solutions yet.”

Many are not optimistic. The Treasury Department and the IRS have limited leeway to change tax rules without congressional approval. So far, legislative efforts to change FATCA and other U.S. tax laws have stalled. “In complex legislation, there are mistakes and things that need to be fixed after the fact,” said Toder.

Technically, Carrie is represented in Congress by the last place she had residence in the United States — in her case, a place she left as a baby. Peter Spiro, an expert on dual citizenship at Temple University School of Law, said this is one reason Americans overseas have little clout in the U.S. political system.

“Their representation in Congress is watered down,” Spiro said.

The simplest option for Carrie may be following Johnson and thousands of others who renounce their citizenship — a growing trend that comes with its own financial burdens, including a potential “exit tax” on high earners. But she hopes to find a way to keep her citizenship.

“I love the United States,” she said.

This article has been updated to make clear that laws requiring U.S. citizens to report their global income predate FACTA. It has also added a note about possible IRS exclusions on income.