While most Americans are in favor of some sort of health care reform, the question of how to pay for it is one that raises a lot of concern. Senate Democrats have picked the low hanging fruit of elective, cosmetic procedures in an effort to fund a nearly one trillion dollar plan.

The five percent tax applies to plastic surgery and non-surgical cosmetic procedures that are not intended to fix a major deformity or disfigurement. Essentially any elective cosmetic procedure, from BOTOX injection to breast implants, would be subject to the excise tax. Based on data over the past several years, the new tax is projected to raise six billion dollars each year.

On its face, this cosmetic surgery tax (called Botax, by some) is no different than any other luxury tax. The presumption is that people that can afford to “splurge” on elective procedures in the service of vanity can afford to pay a little extra to help cover the costs for people that cannot afford basic medical care. However opponents of the bill raise some very interesting points when you consider who is actually going to be affected by this “luxury tax.”

First, cosmetic surgery is predominantly used by women—as many as 90% of cosmetic surgery patients are women. Therefore it has been argued that this is a tax on women. Second, the conception that cosmetic surgery is simply an opulence of the wealthy is not entirely accurate. Studies estimate that the majority of people that elect to have surgical procedures have yearly incomes of less than $100,000.

Literature that shows a woman’s career performance, salary, and promotion schedule is based in some part on physical beauty, a criterion not equally applied to men. Opponents to the tax argue that women are not simply having cosmetic surgery for vanity’s sake, but are doing so to stay competitive in a difficult workplace. The rules may not be fair, but that does not mean that they are not in play. The cosmetic surgery tax comes at a difficult time for women that are trying to get back into the workforce after lay-offs and cutbacks.

Considering that the original Botax was set at 10% and that lobbyists were able to cut that figure in half, it seems that this will be feature of the Senate health care bill that reaches the floor. It is not clear whether the package will pass the Senate at all or whether the bill, once reconciled with the House bill, will still have the Botax.

For people considering cosmetic surgery, right now might be the best time to have it—before the Botax takes effect.