AUGUSTA, Maine - Opponents of Gov. Paul LePage’s plan to divert tobacco settlement money away from the Fund for a Healthy Maine and move it into more direct smoking cessation treatment through Medicaid, turned out in force in Augusta today.
It’s a continuation of a long battle over the use of funds from a huge lawsuit settlement years ago. In 1998, Maine was among the states that settled claims against the major tobacco companies, alleging that the industry had misled the public and the government about the health risks of smoking.
Since then, the companies have been paying out billions in compensation to the states for past, current and future health costs. The payments to Maine have been averaging in excess of $50 million a year.
Department of Health and Human Services Commissioner Mary Mayhew says, under the governor's proposed budget, the money would be used to directly treat Medicaid-eligible Mainers, who have among the highest smoking rates in the state.
"With the Medicaid population representing double the smoking rate of the general population, we need to do something different," Mayhew said. "We believe that the clinical intervention within the primary care practice setting can have a more powerful impact on reducing our smoking rates."
In all, Mayhew wants to shift $20 million away from existing smoking cessation programs, and from school-based clinics that address other problems as well. Moving the funding sources frees up $20 million in general fund dollars for other state needs.
John Blouin, from Readfield, told lawmakers that the state needs to spend more on prevention efforts in order to save on the long-term costs of smoking.
"Health care costs are blowing holes in budgets all over the state of Maine," Blouin said. "The most effective way to limit these expenses is to prevent those costs from happening in the first place, through preventative care. That is what the Fund for a Healthy Maine, local Healthy Maine Partnerships, have been doing effectively."
Among the cuts under the proposal: about $5 million a year from the community health center grants to schools. Rebecca Reynolds, director of the Maranacook High School health center, is opposed.
"By keeping the Fund for a Healthy Maine intact, these prevention dollars are being spent wisely," Reynolds said. "These dollars are working to keep kids healthy and in school where they belong. I cannot think of a more worthwhile use of these funds."
And Bonnie Irwin, from the Friends of a Fund for a Healthy Maine, an advocacy group that has lobbied against efforts to divert money for other state purposes, says reducing prevention efforts will increase health care costs in the future.
"We urge you to understand that, if we abandon proven prevention measures and don’t do all we can to make our kids and young adults avoiding addiction and an unhealthy lifestyles from the start, we will be here having this same conversation for decades to come," Irwin said.
Another couple of million dollars over the two-year budget would be cut from immunization programs because, Commissioner Mayhew says, demand is down, as more Mainers are now covered under the Affordable Care Act. She told lawmakers that smoking prevention efforts are important, and there are other sources for those efforts.
"We are talking about one source of funds here," Mayhew said. "That is not to suggest that there are not other - there are millions of dollars being spent to promote population health, to focus on early intervention and prevention."
This budget proposal will now be considered by members of the Legislature’s Health and Human Services Committee, who will make recommendations to the budget-writing Appropriations Committee. That panel will then put together the more than $6.3 billion two-year state budget for the full Legislature to consider later this year.
