AUGUSTA – With Gov. John E. Baldacci’s sights set on providing universal health care coverage for Mainers, a major part of his reform package involves safeguarding funding for preventive care.
The governor hopes to amend Maine’s constitution to protect the $50 million Fund for a Healthy Maine – the state’s share of a 1998 settlement with major tobacco companies – from being tapped to fill holes in the state budget.
“Forevermore, the dollars available from the tobacco settlement will all be used for health care access, public health and prevention of disease,” Baldacci promised earlier this week as he introduced his first-in-the-nation plan.
His announcement drew a standing ovation from the audience of lawmakers, public officials and other policy-makers. On Thursday, Dr. Dora Mills, director of the state’s Bureau of Health, called the action “bold and admirable.”
“Every legislative session, there are proposals to allocate the tobacco settlement funds differently than the Legislature [originally] decided,” Mills said.
At the time of its formation in 1999, the following uses were identified as appropriate for the Fund for a Healthy Maine: tobacco cessation and prevention, oral health, child care, school health programs, home visitation for families of newborns, substance abuse prevention and treatment, and prescription drugs for the elderly and disabled.
Ed Miller of the Maine chapter of the American Lung Association said the fund was perceived as a unique opportunity to finance disease prevention without taking money away from treatment.
Instead, he said, he and other preventive care advocates have had to defend the fund “year after year in the Legislature to keep it from becoming another Rainy Day Fund.”
Every year about 30 percent of the money in the fund has been moved to the general fund to fill holes in other programs, some medical-related and some not, Miller said. The current biennial budget diverted $51 million from the fund, and at least $6 million has been tapped so far for the upcoming two- year cycle.
Despite the diversions, Miller said, Maine’s tobacco money is better protected and better spent than in most states. Many states have used the settlement to build roads and bridges, he said, and one state built a new morgue.
Some states have set up trust funds and are spending only the interest, while others have opted for a lump sum over annual distributions, losing millions of dollars in the process.
In a recently released survey conducted by the national Campaign for Tobacco-Free Kids, Maine ranked first among the 46 states participating in the tobacco settlement for its use of the funds in fighting tobacco use.
The vast majority of states have failed to invest even the minimum amount, which is different for each state, recommended by the Centers for Disease Control and Prevention. Since 2000, Maine has spent an average of 150 percent of the recommended amount.
The Fund for a Healthy Maine was established when Maine and 45 other states won a major legal settlement from the tobacco industry. Payment of Maine’s share began in 1999 and will continue “forever,” according to Assistant State Treasurer Adam Krea, at least “as long as big tobacco companies exist.”
Payments into the fund are projected to be about $50 million a year for the foreseeable future. From 2008 through 2017, the fund will receive “strategic additions” of about $12 million a year on top of the regular payments to pay for the work of attorneys general who brought the lawsuit, according to Krea.
Miller said a constitutional amendment is the best way to protect the Fund for a Healthy Maine, but it would need to be worded carefully to keep the money safeguarded for preventive uses. He speculated that some lawmakers would argue the issue doesn’t rise to the level of an amendment. Others, he said, would vote against the measure to retain access to the funds.
A constitutional amendment must be approved by two-thirds of both the House and Senate. The measure then would go to Maine voters for simple-majority approval in a public referendum.
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