State Politics

Politicians want to tap Idaho’s tobacco money again — this time for Medicaid changes

Money Idaho receives from a 1998 settlement with the major tobacco firms is often a target for funding new state health care initiatives. This year is no different, with Gov. Butch Otter hoping to use some of it to help pay for adjustments to Medicaid.
Money Idaho receives from a 1998 settlement with the major tobacco firms is often a target for funding new state health care initiatives. This year is no different, with Gov. Butch Otter hoping to use some of it to help pay for adjustments to Medicaid. The Boston Globe

A proposal to use $11.4 million in tobacco settlement dollars to pay for the governor’s “dual-waiver” health care plan caused a partisan rift Tuesday among the Joint Millennium Fund Committee.

The money comes from a 1998 settlement with the major tobacco firms. Four Democrats on the committee suggested the state is morally obligated to use that funding for tobacco prevention and cessation programs, rather than to address other state needs.

“That money can be viewed, in moral terms, as a bribe to the states,” said Sen. Grant Burgoyne, D-Boise. “It’s a kind of bribe to conflict us — we don’t get it if we don’t have a certain level of tobacco use. My goal is to drive usage to zero. ... So let’s not use the money for other things and buy into the (tobacco) industry’s attempt to get us to covet that money. Let’s use it to put the industry out of business.”

However, Burgoyne’s effort to block the $11.4 million shift failed on a 5-4 party-line vote.

“I understand the nature of the motion, but it’s way too restrictive,” said Rep. Stephen Hartgen, R-Twin Falls. “It would complicate an effort to fund a program I think we all recognize needs to move forward in some form.”

Gov. Butch Otter has proposed a dual-waiver health plan that would help about half of Idaho’s Medicaid gap population qualify for premium subsidies through the state exchange; a small number of people with high-cost, complex medical conditions also would qualify for Medicaid.

The plan requires legislative and federal approval — the House Health and Welfare Committee advanced it to the full House Wednesday after a public hearing. It has an estimated cost of $29.3 million. The governor is recommending that $11.4 million come from the tobacco settlement investment earnings, with the remainder coming from the general fund.

The Millennium Fund Committee recommends how tobacco settlement dollars should be used. It has about $15 million to allocate in fiscal 2019, although the joint budget committee approves the actual appropriations.

The five Republicans at Tuesday’s Millennium Fund meeting declined to take a position on the governor’s funding scheme. After defeating Burgoyne’s effort to block the $11.4 million transfer, they recommended using $3.6 million for various tobacco programs that are operated by Idaho’s public health districts and the Department of Health and Welfare. Any unexpended money at the end of fiscal 2019 would go back into the permanent endowment.

Tuesday’s committee action essentially leaves it up to the joint budget committee to decide whether the tobacco dollars should be tapped to help pay for the governor’s health care plan.

“We’re deferring to the budget committee’s judgment,” said Rep. Fred Wood, R-Burley, the co-chair of the Millennium Fund Committee.

The budget committee isn’t bound by the Millennium Fund recommendations, but it typically gives great deference to the germane committees. The whole question of funding could also be moot if the governor’s health plan fails to advance through the Legislature.

Spence may be contacted at bspence@lmtribune.com or (208) 791-9168. Statesman staff contributed.

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