07.30.09

Are These Breasts Deductible?

Hidden inside some of the health-care reform plans is a penalty for plastic surgery and other elective cosmetic procedures. Sandra McElwaine on the so-called Botax—and the mystery surrounding why no one wants to take credit for it.

Although some may think this may be the way to lipo the idle rich, in reality it is working women who would be targeted—those who earn between $30,000 and $90,000 a year, and baby boomers attempting to kickstart or rekindle a career.

The Botax? It’s enough to make you laugh if your face isn’t frozen.

Looking “refreshed,” the buzzword for a brow lift, face lift, or hair transplant, has suddenly surfaced as a novel approach to help finance the troubled $1 trillion health-care overhaul bill and, for once, no one has stepped up to the plate to demand credit for the offbeat idea. (Most lawmakers, it seems, have someone in their immediate circles—perhaps including themselves—who have done some refreshing.)

Although some may think this may be the way to lipo the idle rich, in reality it is working women who would be targeted—those who earn between $30,000 and $90,000 a year, and baby boomers attempting to kickstart or rekindle a career.

Most in Washington heard the news this week from a report in Congress Daily which stated that the Senate Finance Committee was plotting a 10 percent surcharge on all unnecessary cosmetic-surgery procedures, and that the idea had been broached to Chairman Max Baucus (D-MT) during a meeting with Office of Management and Budget Director Peter Orzag in mid-July.

Leaving this confab, Baucus reportedly told bystanders he had heard some “interesting,” creative, and fun ideas. So began a flap over a tax no one wants to claim.

The Senate Finance spokesperson, Scott Moorehauser, dismisses the whole subject of nips and tucks as a “ total non-starter.” “Nothing was ever discussed, and nothing was ever talked out in a committee meeting,” he insists. “Basically this is a non-story. The subject never came up.”

When I called back with another query, I was told he was suddenly unavailable and not answering any more questions. OMB, however, was quick to respond and eager to distance themselves from any form of plastic politics. “No, Peter [Orzag] did not put this idea forward,” says his spokesman Kenneth Baer.

House Speaker Nancy Pelosi, whose “refreshed” looks have spawned constant speculation, is also out of the loop. She has read the all news articles about it, her office says, but had no discussions on the subject. "As far as she knows," says her press secretary Brendan Daly, "it's not being seriously considered.”

So who decided to levy an excise tax on the cushy world of rejuvenation and self-improvement? Some point the finger at the Treasury Department’s economic adviser Gene Sperling, but he is nowhere to be found and the Treasury is silent. No phone calls or emails returned.

The press aide for Finance Committee member Senator Kent Conrad says he was thoroughly mystified when he read the story and thought it was probably a spoof or joke. “Sen. Conrad doesn’t know a thing about it,” says Chris Thorne. “It is one of those bizarre events that happen in Washington and then it gets floated around.”

The American Academy of Cosmetic Surgery, which boasts 2,500 aesthetic practitioners, was equally flummoxed, and vehement in their opposition.” We have no idea who came up with this,” says communications director Charlie Baase. “It’s not a viable solution and doesn’t bring in the proposed revenue.” He argues that it would be discriminatory to females who comprise 90 percent of all plastic-surgery patients. Although some may think this may be the way to lipo the idle rich, in reality it is working women who would be targeted, specifically those who earn between $30,000 and $90,000 a year, and baby boomers attempting to kickstart or rekindle a career. He also warns: “It is important to note that the age bracket most likely to vote in elections is the same as those who are electing to have cosmetic procedures.” (That should snuff out any proposal right there.)

Apparently this type of revenue-raising has been proposed in several states before, with a minimum of success. The only state to adopt such a tax is New Jersey, which has failed to realize expected profits, and is facing strong opposition from the legislators who originally voted for the bill.

According to Dr. Malcolm Roth, a health and policy advocate at the American Society of Plastic Surgeons, the tax only added to the bureaucracy and presented the problem of deciding which procedures were taxable and which were not. There also was the dilemma of determining the fine line between necessary reconstructive surgery and cosmetic enhancement.

“We thought a cosmetic-procedure tax was a creative approach to line deficits in the state budget,” New Jersey Assemblyman Joseph Cryan has said. “It hasn’t delivered. Instead of the $24 million annually, the Division of Taxation has collected only $10 million—only 41 percent of the projections.”

His advice to lawmakers considering such a plan? Refresh.

Sandra McElwaine is a Washington-based journalist. She has been a reporter for The Washington Star, The Baltimore Sun, a correspondent for CNN and People and Washington editor of Vogue and Cosmopolitan. Currently she writes for The Washington Post, Time and Forbes.