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Mayhew Defends Gov's Plan to Cut $20M From Smoking Cessation Fund

AUGUSTA, Maine - The LePage administration is digging in to defend a plan that would cut $20 million from the Fund for a Healthy Maine, an entity created to promote smoking cessation efforts.

Health and Human Services Commissioner Mary Mayhew says the money would be better spent on Medicaid patients who are dealing with a variety of health ailments exacerbated by years of smoking.

Health care advocates say they will organize to fight the proposed cuts from the fund, which they say is critical in the effort to curb youth smoking.

The LePage administration says Maine is just not getting its money's worth from the dollars it spends on tobacco cessation programs. Commissioner Mary Mayhew says, according to one report, the state's smoking rates have remained relatively unchanged for more than a decade.

"In fact, our young adult smoking rates are consistent with where they were in 1992," she says, "and yet we've spent tens of millions of dollars over that period of time."

In fact, according to a new report from the Robert Wood Johnson Foundation, Maine ranks seventh in state spending for tobacco cessation. The money used to pay for smoking cessation programs is derived from the Fund for a Healthy Maine, which was created with money from the settlement with the tobacco industry.

Gov. Paul LePage has proposed transferring $10 million a year from the fund to help Medicaid patients. The money would draw down federal matching funds that would go to health care providers. And Mayhew says it's appropriate use of those tobacco settlement funds.

"The smoking rate within Medicaid is a huge problem, with 42 percent smoking rates, this is why this proposal is so critically important," Mayhew says. "We need $28 million to support primary care physicians, to support their role in screening and their focus on prevention and early intervention around tobacco-related illnesses. These funds will absolutely help to support that effort."

"Well, we're very pleased to see that the administration is now concerned about the smoking rate with the Medicaid population," says Ed Miller, executive director of the American Lung Association of Maine. Miller says it was only last year that the Legislature overrode LePage's veto of a measure to create a best-practices tobacco treatment benefit for the Medicaid population.

But Miller says Mayhew and LePage are wrong if they believe that it's necessary to de-fund tobacco prevention programs in order to further good treatment methodologies.

"We don't feel that cutting off funding for community-based prevention programs which go well beyond tobacco, these community interventions are not just dealing with tobacco," Miller says. "In fact, in our opinion they're not doing enough - they're only spending about 50 percent of what the federal Centers for Disease Control say should be spent on tobacco. To cut that off and then say that the way to address this problem is through primary care is a false choice."

And opponents of the governor's plan worry that the state could take several giant steps backward if it fails to maintain its tobacco prevention efforts. Tina Pettengill, executive director of the Maine Public Health Association, says the LePage administration is inviting that very outcome by diverting smoking cessation funds.

"We know from other states who have done what the governor is suggesting, who have invested great resources and then stopped those investments, we know that the tobacco rates by use will go up if we stop these investments," Pettengill says.

DHHS Commissioner Mary Mayhew says it makes little sense to invest taxpayer dollars in programs that are underperforming.

"The dollars spent under the Fund for a Healthy Maine simply must be scrutinized like every other dollar in state government," she says, "and we've got to create accountability and performance expectations that truly the money spent are producing better outcomes."

Mayhew says department studies show that the Medicaid clients she is trying to reach are more likely to pay attention to a doctor than to a tobacco prevention program.