A Healthy Margin 

What will Montana do with its share of the tobacco money?

Last month Montanans said yes by a healthy margin to Constitutional Amendment 35, which created a trust fund out of the state’s share of settlement money following a successful multi-state lawsuit against the tobacco industry.

Now the question is: How do we spend it?

The nuts and bolts of CA-35 are a bit complex. Montana’s share of the tobacco lawsuit money amounts to $832 million, to be doled out in annual payments of approximately $30 to $35 million over a 27-year period ending in 2025.

CA-35 allows 40 percent of those annual payments to be placed into a tobacco trust fund. Ninety percent of the interest generated by those annual deposits will be spent on tobacco use prevention programs and on the health care needs of Montanans suffering from tobacco-related diseases, such as cancer and emphysema. The remaining 60 percent is slated for the state’s general fund, which pays the operation and maintenance costs of running state government.

Considering that Montana’s health care safety net is mighty thin, or practically non-existent, and that, according to Cable News Network, 22 percent of Montanans have no health insurance, one might expect the public to be clamoring for that tobacco money. At the very least, one might expect that health care-related special interest groups would be hard at work lobbying their legislators for their share of what looks to be, at first glance, a very large pie.

It may be a bit premature for lobbying and clamoring, however.

Bill Thomas (R-Hobson) is chairman of the Human Services Committee in the Montana House of Representatives. His committee, he says, will be the one that will likely deal with the issue of divvying up the trust fund money. Though the Legislature will convene in less than two weeks, Thomas says he has not spoken with anyone in the health care field about the tobacco trust fund or how the money should be spent. And he knows of no pending legislation regarding the trust fund. “No one has mentioned anything to me,” he says, apologizing for his lack of information. “It’s quite a bit of money and it should be spent carefully.”

Thomas is a retired dentist with an interest in the dental needs of uninsured and low-income Montanans. And he believes that a portion of the tobacco trust fund might be well spent on providing dental care to the state’s less-well-off citizens. “I’m very interested in oral health. That’s where a lot of cancers are found,” Thomas says. He also supports Montana’s fledgling tobacco use prevention program.

That’s good news for the American Cancer Society and the Centers for Disease Control and Prevention. According to Kristin Nei, state advocacy manager for the American Cancer Society, Montana’s anti-smoking program was created by Gov. Marc Racicot and has been funded by the Legislature for the past two years to the tune of $3.5 million a year. In a state that was largely bypassed by the great economic boom of the ’90s, $3.5 million could be considered quite generous, especially considering that anti-smoking programs tend not to show immediate results. But from the CDC’s point of view, it’s a paltry sum. The CDC recommends that states spend between $9.3 and $19 million a year to persuade its smoking citizens to give it up. In Massachusetts, for example, well-funded anti-smoking programs resulted in a 20 percent decline in tobacco use, Nei says. Likewise in California, smoking declined by nearly 8 percent in only three years, again thanks to well-funded anti-smoking campaigns. In Montana it’s too early to tell how successful the five-year tobacco use prevention program has been because it’s only been in full swing for about 15 months. But last Monday, the American Cancer Society and three other health organizations praised Montana’s Tobacco Use Prevention Program at a ceremony in Helena, for what they called “outstanding achievement” in carrying out the first stages of Montana’s campaign against tobacco.

While beefing up the program will likely be the first claim on the state’s tobacco trust fund, there’s no immediate need to beat other claimants to the money. Interest money that can be spent on anti-smoking programs and health care won’t build up to significant levels for several years. State officials have estimated that the first interest payments—estimated at $889,849—won’t be available until 2003. “What [the American Cancer Society] will be supporting is that the tobacco use prevention program in Montana be fully funded,” Nei says.

Meanwhile, legislation that creates a structure for managing the trust fund will be debated in the 2001 Legislature. Nei and Thomas say that at this early stage, no one knows how, precisely, the trust money will be spent.

But one thing the Legislature can probably count on is a lobbying effort on the part of health care professionals to spend the remaining amount—the percent that is to be deposited into the general fund—on health care for Montanans.

Says Nei: “We would like the Legislature to review the remaining 60 percent as money that should be used for the intent of that settlement. It should be spent on the health care needs of the state.”

And that’s where the real battle lies. Legislators will likely be tempted to spend that windfall on tax relief for property owners, or to fund a variety of non-health-related programs.

Nei agrees that the battle for the 60 percent will require the American Cancer Society and other similar programs to launch an extensive lobbying and education effort of the Montana Legislature.

And though Montanans may ultimately see the remaining 60 percent spent on roads, prisons, schools, wildlife habitat or any program unrelated to health care, Montana voters made a wise choice by creating the tobacco trust fund. “I do think Montana is on the right track,” Nei says.

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