Cosmetic Surgery Tax

The Senate has reinstated a tax on cosmetic surgery procedures. The current provision states: ''There is hereby imposed on any cosmetic surgery and medical procedure a tax equal to 5 percent of the amount paid for such procedure (determined without regard to this section), whether paid by insurance or otherwise.

''(b) COSMETIC SURGERY AND MEDICAL PROCEDURE.-For purposes of this section, the term 'cosmetic surgery and medical procedure' means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which-
''(1) is performed by a licensed medical professional, and
''(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease.

Do you see loop holes or problems unforseen by the Senators in this change of our tax code?

Doctor Answers 20

Cosmetic surgery tax!

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This inappropriate and unfair "sin" tax has reared its ugly head again, only now in the U.S. Senate. It is amazing how our government looks for any way it can to creatively take money from the citizens in order to fund its excessive spending.

In my practice, 98% of my patients are women so this is clearly discrimination against them. Secondly, not all cosmetic patients are as wealthy as congress would like you to believe. The average income of cosmetic surgery patients is under $60,000 so this is not a tax on the super-rich but rather on normal every day citizens.

This also is a logistical nightmare to administrate as was discovered in New Jersey when they tried such a tax a few years ago and eventually abandoned this as a bad idea. If a state can't administrate this plan, imagine the debacle which would ensue if the exceedingly inefficient federal government tried its own version!

Every reader on RealSelf should send an email to their Senators today and tell them to strike this discriminatory tax from the health care bill under review. I have already sent my 2 senators my opinion!

Bad Health Care Bill, Unfair tax

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The Senate has clearly chosen expediency over fairness with this tax. The health care bill fails to address the real financial and decision making problems in health care: the massive administrative cost of health insurance companies, the bloated profit margins of health insurance companies, the medical decision making practiced by insurance companies, the cost of defensive medicine (vis a vis the lack of meaningful tort reform), and the cost of pharmaceuticals. Instead, the Senate has decided to appease a major financial lobby, pushing through a bill that will only benefit insurance companies. In so doing, our elected representatives have decided to choose arbitrary and capricious means to pay for it. Given the bungled mess that this health care bill is, I wouldn't be surprised if the cosmetic tax was filled with loopholes.

Botax, or tax on cosmetic surgery - morality tax on women

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These laws have not passed yet, but they are ominous for any patient contemplating plastic surgery. Depending on the laws the individual states enact, this tax could be as high as 15%, payable by all patients on all services not strictly reconstructive. And we know from the insurance companies what constitutes reconstructive--- almost nothing. With the huge regulations already in place, and more in the pipeline, costs of plastic surgery are already high. Add 5% to 15% to that figure. These transactions will be heavily audited, so expect the government to be inspecting your cosmetic surgery files carefully.

Many patients are in fact rushing to book their surgeries ahead of any tax increase, even though their surgery is scheduled far ahead.

No surprise that lawyers fees were not taxed, ironic given the number of lawyers making the laws.

If every patient voiced their objection to their state and national level, the provision will not be passed; the squeaky wheel gets the grease, as they say.

Patients who have had plastic surgery know that the improvement in their self esteem and in many cases their social or professional positions as a result of plastic surgery should not be penalized by by what is essentially a "morality tax" on women.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

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Every RealSelf reader should try to contact their local representatives

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Where does Congress draw the line on what is a cosmetic procedure? Is getting tooth whitening considered for a 5% tax. How about using mascara or make up. Clearly we do not need any of these "frivolous" adjuncts, but try telling that to a woman with a AA chest who has never been able to buy a bra or bathing suit that fits.

Is a body wrap at a spa aimed at reducing inches not taxed but one done at a doctor's office taxed. The great majority of patients who have cosmetic surgery are not the rich and famous. This is a tax on patients who earn a lot less than the congresspeople who are imposing it.

Unforseen problems by the Senators in tax code change

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No, I do not. I think the US Senate under the inspired leadership of Mr. H. Reid (D- Nevada) will long be remembered as a shining example of fiscal responsibility, self restraint, selfless impartiality, bipartisanship and never before seen awesome blinding intellect in everything they have done for us for the past 3 years.

This latest example of what we can expect from this august body fully demonstrates that past lessons were and will never be learned.

Yes. I think I will spend the next 30 hours sifting through 2,047 pages of Democratic lawyer speak and babble to see if I can pick another very rare example of blinding stupidity.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Problems with cosmetic surgery tax

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The current senate health bill in Washington D.C. has a proposal to tax medical procedures equal to 5% of the amount of the fee the patient would pay to the surgeon. The surgeon will have to collect sales tax and submit that to the Internal Revenue Service. There are many problems in this type of taxation proposed by the U.S. Senate to the tax code. This is an unfair discriminatory tax against women since women represent 80% of plastic surgery practices. In addition, it will be very difficult to collect since many procedures are sometimes covered under insurance and sometimes not. An example of this would be an upper blepharoplasty done for insurance purposes such as visual impairment versus cosmetic purposes. This sets a very bad precedent and will now allow the IRS to audit plastic surgery practices to make sure patients have paid their tax on cosmetic procedures.

Nothing but loopholes

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A very poorly thought out tax on the middle class. 90% of those that choose plastic surgery come from family incomes of less than 90,000 a year. Thus this is a middle income tax. If Obama signs the bill, he lied to the American public.

What is a cosmetic procedure. Consider hair color, tattoos, body piercing, scar revisions, hair extensions, manicures. All performed by "professionals" and not intended to enhance body function.

The entire health care package as outlined by the House and Senate is dopey. Let's hope they can forget the crap and make some real changes that help people and not grab money and power for Washington.

Cosmetic Surgery Tax may be unconstitutional

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There has been lots of valid arguments presented before I had an opportunity to make mine. I raise questions whether a selected group can be subjected to increased taxation. Taxation by our constitution should not be discriminatory yet this one appers to be discriminatory for geneder, for specialty and selectivley affects one group more than others.

When is reconstruction considered cosmetic and when is cosmetic considered corrective? Bo-Tax will be another convoluted and ineffective tax. It will be more costly to implement than the revenue it collects. I suspect that Botox will be used to treat migranes more often than wrinkles. Legal classifications will multiply and only the legal system will benefit from the contensions.

Implement a fair legal liability reform in medical issues and the monetary savings will eclipse any bo-tax they set out to implement.

Julian Henley, MD
Greeley Facial Plastic Surgeon

Plastic Surgery Tax is a bad idea

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Help fight a bad idea!! Congress is soon to debate the Health Care Reform Bill, which is a great move towards increasing the number of insured Americans. Unfortunately, it is filled with several bad ideas, like a taxation on patients who undergo cosmetic surgery.

This has been attempted previously in New Jersey, and has failed miserably- A government auditor will be the one to decide whether your surgery is cosmetic or reconstructive, a necessity or a luxury. This tax additionally discriminates against women and the middle class, who are the two groups most likely to undergo aesthetic surgery. Finally and most concerning, this taxation will encourage more patients to go overseas for their plastic surgery, inevitably resulting in more complications in patients returning to the US. With treatment of these medical and surgical complications, health care spending with respect to these botched plastic surgeries is likely to INCREASE, rather than decrease.

Please, email and call your congressional representatives and Senators, and encourage them to oppose this taxation. It’s not only unfair, but unsafe for Americans.

Effective ways to reach your Members of Congress include:

1. Call your Senators and Representative’s District Office this week. Most legislators are home this week for the holiday break.
2. Call Your Senator and Representative’s Washington, DC Office (early and often).
3. E-Mail Your Senators and E-Mail your Congressperson.
4. For Patients: The U.S. Capitol switchboard is 202-225-3121 where your patients can be connected to their Senators and Representatives.

NOTE: The patient must know the name of their Senator prior to calling the switchboard; this information can be found at (scroll by state). They can determine the name of their representative by going to where they can enter their zip code.

Privacy issues are one concern? What is cosmetic? Will the government tax combing your hair?

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Of course there will be loopholes. I doubt the countless senators and congressmen and women who receive cosmetic surgery services and Botox (and deny it) will pay for it out of fear of a paper trail.

If tax records are a matter of public record, then how will this be reinforced without sacrificing HIPAA violations? If I treat Patient X for Botox and document the tax and then get audited, won't the IRS know whom I've treated. The details need to be worked out.

However, I see it as discriminatory. Why don't they tax (they may in the future):

  1. hair styling (cuts and coloring),
  2. hair extensions,
  3. tanning salons,
  4. massages, facials,
  5. spa treatments,
  6. laser hair removal,
  7. microdermabrasion,
  8. mannicures/pedicures
  9. etc.

WHERE DOES IT END? These are services and so are cosmetic surgery procedures.

Furthermore what constitues a congenital deformity: a big nose, a small chin, crooked teeth, male breasts, prominent ears, etc? Currently, these are considered cosmetic but easily could be interpreted as congenital deformities as they were in the early 80's

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.