Closing the Medicaid gap can’t come at the expense of programs to fight tobacco

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State legislators are introducing multiple bills that would reallocate Millennium Fund dollars, funds from the Master Tobacco Settlement currently used for tobacco prevention, education, and cessation, to help close the health coverage gap in Idaho. Unfortunately, these efforts simply shift funding from one area of health to another, leaving both inadequately funded, and leaving Idahoans’ health at risk. Clearly tobacco use and healthcare coverage are critical health issues that our state needs to address, and this legislation forces a choice between them, to the detriment of both.

Nearly 20 years ago a hard-fought settlement between states and the tobacco industry provided a pittance of money when compared to the damage caused by tobacco. Idaho invested those dollars, creating the Millennium Fund, dedicated to prevention and cessation efforts. These dollars have supported important programs educating and empowering youth to never use tobacco products, as well as programs that help current smokers quit, like Project Filter. States that have reallocated tobacco prevention funds from the settlement provide a crystal ball for Idaho legislators. When Florida stripped funding from prevention programs, they saw increased smoking rates among youth, and when voters wisely reallocated dollars back to tobacco prevention, youth smoking rates started to decline again. Idaho cannot afford the same mistake.

We must fight to protect Idahoans from dangerous tobacco products that when used as directed, kill half of their users. The tobacco industry makes campaign contributions to nearly all of our state representatives and spends more than four times more money marketing their products than is spent by the Millennium Fund. Smoking prevalence in Idaho has flatlined at around 15 percent after declining over decades. One in four high school students use e-cigarettes in Idaho, many of whom will become addicted to nicotine, and begin smoking standard cigarettes. Tobacco use is still the No. 1 preventable cause of death in Idaho.

In many ways, the tobacco industry is winning again. The Senate State Affairs Committee recently voted not to move forward a bill that would raise the legal sales age of tobacco to 21. This legislation had no price tag attached and would have a large impact, as approximately one-third of regular smokers become addicted between the ages of 18-21. It was an alternative to previous efforts to reduce tobacco use that were met with resistance and rejection in the Legislature. The tobacco industry is delighted to see tobacco control redirected away from youth, their most important market, through a defeated Tobacco 21 measure and now proposed reallocation of Millennium Funds.

There simply are not enough Millennium Fund dollars to be a sufficient solution to providing health care coverage to the uninsured. Meaningful action is necessary to ensure health care coverage, but using tobacco use prevention funds to attempt partial coverage is a Band-Aid at best, and will only increase health care costs in the long run by undermining prevention efforts. We demand a better solution.

Dr. Ryan Lindsay is an assistant professor in the Department of Community and Public Health at Idaho State University and the current president of the Idaho Public Health Association.

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