GST reforms bring no relief for differently abled

Bengaluru: The GST rationalisation set to take effect from September 22 has given a raw deal to the differently abled, as there is no change in tax slabs for a host of disability aids, according to doctors, patients and activists. 

While numerous household essentials and luxury items will see GST cut or exemption, there will be no change for various medical devices — prostheses, walking sticks, wheelchairs, crutches, cochlear implants and so on — used by the differently abled. 

Prosthetic kits such as artificial limbs are taxed 5% while other accompanying parts, such as silicon sleeves, straps and belts required to attach them to the body, attract 18% GST. 

Health insurance does not cover most of these aids. 

“The basic models for leg prostheses start at Rs 45,000 but the cost goes up to Rs 75,000 for updates such as a multiflex foot,” said Dr Marcelle Samuel, head of orthopaedics department at a Bengaluru hospital. 

In the case of sleeves, the basic model starts at Rs 5,000 while silicon sleeves cost above Rs 20,000. 

“Many patients complain about the price, calling it expensive, so we give them the choice to go for the basic models to get used to for a couple years and then save up for a better model later,” Dr Samuel told DH. 

Patients are often left to choose between functionality and pain. 

A woman in her 20s, who lost her leg to gangrene two years ago, said she opted for a basic below-knee ankle prosthetic because she could not pay Rs 1.15 lakh for the silicon block leg prosthetic that her doctors had recommended.

“And now, I have developed a back issue because it did not sit right with me and I kept limping.” 

Insurance did not cover prosthetics or the silicon caps, she added. 

There is no GST on hearing aids but their repair or servicing is taxed 18%, none of which is covered by insurance. 

Hearing aids cost between Rs 70,000 and Rs 7.5 lakh depending on the model. “While basic models are not that expensive, some patients need models with special features that tend to be more expensive,” said Dr Amitav, an audiologist. 

Cochlear implants, also called artificial electronic ears, are taxed at a 5% concessional GST rate while their accessories attract applicable GST, usually capped at 18%. 

Vipul Bansal, Commissioner of Commercial Taxes, Karnataka, said: “Healthcare services are not charged under GST but medical equipment are capped at 5%, mainly because GST moves on the principle of value addition. If the raw material used for making an equipment is already taxed and the value is added to it upon production, then, as a customer, you are just paying tax on the increment on the value of the end product. That is why we cannot cut down on the GST on medical equipment.” 

Sharath Kumar, in his early 30s, who lost his arm in an accident in 2015, said reducing GST on disability aids would really help because these are already expensive and are often not covered by insurance.  “I just recently paid off my medical debt on my surgery and arm prosthetic because it was not covered by insurance,” he said. 

Another aspect that affects the differently abled is the GST on vehicle purchases.

According to a notice by the Ministry of Road Transport and Highways, dated November 13, 2020, differently abled are allowed to buy and modify vehicles to their needs provided that the modifications are not safety hazards.

As part of the previous GST laws, the differently abled purchaser could avail a discount of 10% on GST for heavy motor vehicles (28%), but had to comply with certain rules such as the vehicle cannot be over 1,200 cc or 4,000 mm in length. This poses a problem as the modifications needed for wheelchair users result in the vehicle's length crossing four metres. 

"I wanted to upgrade my car from a Maruti Suzuki Brezza to a Hyundai Creta, but because a Creta is 4,330 mm long, if I were to purchase it, I would not qualify for the discount on GST," an arm amputee told DH. 

As part of tax reforms, small cars are now capped at 18% GST, and there are no notifications on discounts for the differently abled yet. "We hope they bring it down to 5% or 10% at least," he added.