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					Dear [Insert Name of Senator or Representative] ____________________________:

As one of your constituents from __________ [insert City or Town], Washington, I strongly
encourage you to oppose the proposed sales tax on cosmetic surgery being considered in House
Bill 3191 or in any final revenue package.

The tax would have unintended, detrimental consequences. In addition, it would generate
significantly less revenue than anticipated. Some of the detrimental consequences include:

First, revenue would not meet expectations, as seen in New Jersey, the only state to pass a
specific tax on cosmetic surgery. New Jersey projected $26 million in revenue from the tax; but,
it has realized only $7 million. Moreover, it incurs $3.39 in costs to collect $1.00 in cosmetic
surgery taxes. Significantly, the New Jersey legislator who sponsored the cosmetic surgery tax
bill is now trying to repeal it.

Second, administration of the program would be extremely costly and inefficient. Importantly, it
potentially would violate patient confidentiality laws and regulations, especially if revenue
officials are required to review patient files in order to determine whether a procedure was in fact
medically necessary.

Third, the line between cosmetic and reconstructive surgery is not well defined. Even health
insurance companies struggle to distinguish between cosmetic and reconstructive surgery.
Consider the following: Is it cosmetic to reconstruct a nose that is large and unattractive but
also does not breathe well? Are heavy eyelids considered a detriment to vision, or is it a
cosmetic surgery to have them reconstructed? Is pinning back the ears of an eight year old boy
who is ridiculed daily by his peers considered cosmetic?

Fourth, the tax unfairly discriminates against women and the middle class, who are the groups
which seek cosmetic procedures in the greatest numbers.

For these reasons, I strongly urge that you not include a cosmetic surgery tax in any final revenue
package. Medical procedures should not be part of bridging the budget shortfall.

Thank you for your serious consideration of these important issues.


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