*** LEGISLATIVE ACTION ALERT ***

STOP THE COSMETIC PROCEDURES TAX!!!

WASCA urgesits members to take prompt action to thwart a provision in the health reform legislation currently under debate in the United States Senate which would adversely affect Ambulatory Surgery Centers and many patients treated in them. The “Patient Protection and Affordable Care Act” would impose a 5% federal tax on cosmetic medical procedures (“Excise Tax on Elective Cosmetic Medical Procedures,” page 2045, Section 9017).

Ambulatory surgery centers would more than likely be responsible for collecting this tax on the ASC and anesthesia components of any cosmetic surgery. This would place significant additional expense and administrative burdens on ASCs. Furthermore, this type of selective taxation of health care services establishes a bad precedent, opening the door for like proposals in the future. For these reasons, and the other reasons cited below, WASCA strongly urges its members to contact Senators Maria Cantwell and Patty Murray expressing opposition to the imposition of this tax on cosmetic surgery.

The following reasons have been widely cited in opposition to a tax on cosmetic surgery:

  • Difficulty to Administer: No clear, definitive guidance exists to differentiate cosmetic procedures, which would be taxed, from reconstructive procedures to correct deformities stemming from injury or disease, which would be exempt from taxation. ASCs and cosmetic surgeons would be on the front line in dealing with the federal government to justify which procedures they considered taxable and which were reconstructive. The same procedure performed on two different patients may be taxable for one, but not the other. Implementation of a subjective tax will require an inordinate amount of time to interpret and administer.
  • Discrimination Against Women: According to a study performed by the American Society of Plastic Surgeons (ASPS), 86% of cosmetic surgery patients are women. Women are under more pressure to maintain a youthful appearance. Cosmetic surgery is frequently used to enhance self-image and self confidence. Imposing a tax on procedures that are primary used by women, and to benefit women, is discrimination against women.
  • Unfair Burden on the Middle Class: The ASPS study showed that 60% of patients planning to have cosmetic surgery within two years have an annual income of $30,000 to $90,000. 40% of that group has an annual income of $30,000 to $60,000. Only 10% of cosmetic surgery patients have an annual income of more than $90,000. Imposing a tax on cosmetic surgery patients unfairly burdens middle class citizens.
  • Patients May Go Elsewhere for Cosmetic Surgery: When faced with a 5% excise tax on cosmetic surgery procedures, patients may choose to have their procedures performed in a foreign country where the cost of the procedures is less than in the United States. New Jersey, which passed the nation’s first tax on cosmetic surgery, has experienced a 59% shortfall based on projected cosmetic surgery tax revenue estimates, presumably because New Jersey patients are going to other states for their procedures. New Jersey has found the tax to be expensive to administer and has generated only minimal revenue. Joseph Cryan, the sponsor of New Jersey’s tax on cosmetic surgery, is now leading efforts to repeal it, and is opposed to other taxes on cosmetic surgery.
  • Cosmetic Surgery Tax Does Not Further the Goals of Health Care Reform: According to President Obama, the goal of health care reform is “to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don’t, and that lowers costs for families, businesses and governments across the country.” Since cosmetic procedures are not generally covered by insurance, the proposed cosmetic surgery tax would not reduce insurance premiums. Costs would increase not decrease, because of the added administrative burdens for ASCs and physicians’ offices.

WASCA strongly encourages all of its members to write or call Senators Maria Cantwell and Patty Murray to express your opposition to the tax on cosmetic surgery. The contact information for Senators Cantwell and Murray is:

Maria Cantwell (D – WA)

511 Dirksen Senate Office Building

Washington, D.C. 20510

(202) 224-3441

Patty Murray (D – WA)

173 Russell Senate Office Building

Washington, D.C. 20510

(202) 224-2621

For your convenience, we have provided a sample letter which you can personalize and send to the Senators.

Take action NOW to avoid imposition of this harmful and misguided measure!

SAMPLE LETTER TO SENATORS CANTWELL AND MURRAY

Dear Senator ______:

As one of your constituents from ______(City/Town), Washington, I write in strong opposition to Section 9017 (“Excise Tax on Elective Cosmetic Medical Procedures”) included in the “Patient Protection and Affordable Care Act.” Imposition of this tax is bad public policy for many reasons.

The tax would be difficult and expensive to administer by all groups involved, including physicians, surgery facilities, and the federal government. The line between cosmetic surgery and reconstructive surgery is not well defined, and would require an inordinate amount of time to interpret and administer. New Jersey, which was the first state to implement such a tax has seen revenues far below what was projected, and high administrative costs for the program.

The tax discriminates against women and the middle class since working women comprise 86% of cosmetic surgery patients, and 60% of patients planning to have cosmetic surgery within two years have an annual income of $30,000 to $90,000. 40% of the latter group reports having an annual income of $30,000 to $60,000. Imposing a tax on procedures used primarily by women to benefit women, and by the middle class, discriminates against both women and the middle class.

Finally, the tax on cosmetic surgery does not further the goals of health care reform. According to President Obama, the goal of health care reform is “to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don’t, and that lowers costs for families, businesses and governments across the country.” Since cosmetic procedures are not generally covered by insurance, the proposed cosmetic surgery tax would not reduce insurance premiums. Costs would increase not decrease, because of the added administrative burdens for surgery centers, physicians’ offices, and the federal government.

For these compelling reasons, I strongly urge you to help stop this tax on cosmetic medical procedures. Medical procedures should not be part of any health reform legislation.

Thank you for your serious consideration of the issues I have raised in this letter.

Sincerely,