“Botax” in Senate Health Bill Could Hit Cosmetic Dentistry

There's a new addition to the Senate health care reform bill that could have massive consequences for dentistry: a proposed 5% tax on cosmetic surgery and procedures that has been dubbed the Botax.

While it's not entirely clear what this would include, cosmetic dentistry will probably be included.

The Senate bill doesn't define cosmetic surgery, but it seems likely it would be similar to New Jersey's tax.

In New Jersey, cosmetic procedures are subject to a 6% tax. (In effect since 2005, it's the only state with such a tax.) It defines “cosmetic medical procedures” as those that are performed to improve appearance without providing significant health benefit.

The state's Treasury website provides a specific example:

"For example, charges for teeth whitening will be taxable, while charges for breast reconstruction or for vision correction by laser treatment will not be subject to the gross receipts tax."
- New Jersey State Treasury

New Jersey has netted about $11 million annually from the tax — half of what was expected.

One of the unintended consequences of the tax? Patients heading to neighboring states for aesthetic procedures.

Senators hope the proposed national cosmetic tax could raise $5 billion annually to help pay for providing health coverage over the next decade.

I'm not comfortable with trying to distinguish "cosmetic medical procedures" from ordinary medical procedures — at least not when it comes to dentistry. Presumably porcelain veneers will be taxable and root canals won't be… but who's to say a dental implant with a beautiful dental crown won't be considered a "cosmetic" procedure?

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