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The surcharge is levied on the manufacturer of certain medical devices, including things like tongue depressors. It is not a sales tax as such since it is applied to gross sales at the wholesale level which is passed on to the suppliers and retailers.
In essence it is similar to a VAT that is common in Europe.
Obamacare And Entrepreneurs: What You Should Know; How To Prepare - Forbes
In essence it is similar to a VAT that is common in Europe.
A 2.3% tax on medical-device sales, not profits, was imposed under the theory that sales to medical-device companies would surge after patients newly insured by the Affordable Care Act poured into the system. What the industry lost in margins, it was supposed to make up in greater volume.
That calculation ignored the fact that the vast majority of medical-device consumers already are covered by Medicare, Medicaid or private insurance. So there will be little or no increase in sales volume to offset the added cost of $30 billion—according to the Congressional Budget Office—to the industry. This tax comes straight out of a company's bottom line. Because many devices are sold to hospitals, physicians and other providers through multiyear contracts, the prices are already locked in, so the tax cannot be passed on to the buyer.
The hit will be severe. For a typical company, a 2.3% tax on revenues equals a 15% tax on profits. When combined with a 35% corporate tax and state corporate taxes, the tax rate for the medical-device industry will exceed 50% in most jurisdictions. Many marginally profitable businesses will then hemorrhage red ink, since they'll have to pay the excise tax whether they are making money or not.
Especially hard hit could be the hundreds of small companies developing medical software applications. These apps promise to revolutionize the practice of medicine—for instance, by delivering blood-sugar test results for diabetics. The IRS is deciding now whether to treat apps as medical devices subject to the tax
Obamacare And Entrepreneurs: What You Should Know; How To Prepare - Forbes