Protection sought for Healthy Maine Constitutional amendment proposed

AUGUSTA – The Fund for a Healthy Maine is headed for protection under the state’s constitution. With a 10-4 vote, members of the Joint Select Committee on Health Care Reform Wednesday sent a constitutional amendment proposed by Gov. John Baldacci to the Legislature with an ought-to-pass stamp.

The measure, if it wins the votes of two-thirds of both the House and Senate, must get popular approval from Maine voters in a November referendum. If it passes both these hurdles, Maine will become the first state in the nation to safeguard constitutionally its share of a 1998 settlement with major tobacco companies.

The Fund for a Healthy Maine was established in 1999. Each year it receives payments of $50 million to $60 million from the tobacco industry. The fund was supposed to be dedicated to preventive health care services, with a special focus on tobacco-related illness.

Since its founding, the Fund for a Healthy Maine has paid for tobacco cessation and prevention programs, oral and dental health services, child care, school health programs, home visits to the families of newborns, substance abuse prevention and treatment, and prescription drugs for the elderly and disabled.

But every year, according to the Maine Chapter of the American Lung Association, some of the fund gets moved into the state’s General Fund to fill spending gaps in other programs. Maine’s current biennial budget is using about $51 million from the tobacco settlement for nonprevention purposes, and the next budget cycle has tapped at least $6 million.

“Forevermore, the dollars available from the tobacco settlement will all be used for health care access, public health and prevention of disease,” Baldacci said last winter when he made his pitch for the amendment.

The governor’s bill specifies allowable expenditures of the money and prohibits its use to replace appropriations from the General Fund or other sources.

Two changes were proposed by committee Republicans on Wednesday.

Rep. Sawin Millet, R-Waterville, suggested the fund might be tapped for other uses with a two-thirds override by House and Senate members.

Rep. Kevin Glynn, R-South Portland, proposed allowing the Legislature to use funds for other health care programs in tight budget times.

Committee co-chairman Sen. Michael Brennan, D-Portland, supported the override measure, calling it a “prudent proposal,” but both measures were turned down by the committee in favor of absolute dedication of the fund.

Dr. Dora Mills, director of Maine’s Bureau of Health, applauded the committee’s action. Although the Legislature generally has done a good job of protecting the fund, it is still an easy target for cash-strapped budget planners, she said. Because the services are preventive in nature, the impact of reduced spending may not be seen for several years.

Although tracking the benefits of preventive care can be tricky, each of the spending areas has its own evaluation process in place, Mills noted. For example, the smoking rate among Maine high school students has dropped from 39 percent in 1997 to 25 percent in 2002, she said. It’s a clear benefit of the $14 million being spent each year in the state to discourage teen smoking.