One of the least publicized provisions of the current healthcare reform bill debated in the Senate is a 5% tax on all “unnecessary” plastic procedures. The proposal, also know as the “BoTax,” is expected to raise around $6 billion over 10 years, merely a drop in the bucket to cover the near $1 trillion cost of the bill.

The new tax would be paid by any patient that undergoes plastic surgery that is not due to deformities related to congenital abnormalities, injuries related to accidents, or disfiguring diseases. Rather, it will mainly apply to breast implants, tummy tucks, liposuctions, Botox injections and other elective plastic procedures. There were 12.1 million cosmetic procedures in the U.S. in 2008, a 3% increase from 2007.

Not surprisingly, the main opponents of the proposed bill are the plastic surgeons. The American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) called the tax “discriminatory, arbitrary and ineffective.” These groups argue that since 86% of plastic surgery patients are female, the tax effectively discriminates against women.

Moreover, they argue that this will not be a tax against rich people only, as evidence suggests that more and more middle-income people are seeking plastic surgery. The latest ASPS survey suggests that 40% of plastic surgery patients report a household income of only $30,000-$60,000 per year.

Another argument made against the bill is that while the proposal relates only to “unnecessary” cosmetic surgery, it is often very hard to tell whether a certain procedure is purely cosmetic or not. Under the bill, it will be up the doctors to determine the medical necessity of a certain procedure.

If the Senate reform bill passes in its current form, it remains to be seen whether the new tax would cause some people to rethink their plastic surgery plans. After all, for an $8,000 breast-lift procedure, what is an additional $400?