Due to the signing of the Federal Health Reform Bill, in 2013 a 2.3% an excise tax will be assessed on the sale of all medical devices in the United States, this includes dental equipment and dental prosthetics. Unlike most taxes, this tax is assessed regardless of a company’s profitability, leading to a burden on the balance sheet. This tax will increase costs to all medical and dental providers. The government offers the argument that the marketplace will be expanded by 32 million people through mandated healthcare. This is of little consequence to the dental industry that is primarily on the outside looking in on ‘healthcare’, while still subject to the excise tax.