Bill would move money to kids' health insurance program

In a hearing Friday evening, Hamilton Republican state Rep. Ron Marshall advocated for his bill to take half of the funding that tobacco prevention efforts in the state get from a tobacco settlement and put it toward the state’s children's health insurance program.

Montana receives cash annually from a 1998 settlement agreement that was struck between 46 states and 60 tobacco companies over the cost of tobacco-related health care. In 2020 the state got about $24 million from the settlement, which is based on cigarette sales. The number has generally decreased over the years as fewer people smoke, said several people who testified against the bill last week.

Of the 40% of the funding that goes into the state tobacco trust fund, 32% goes to tobacco prevention and 17% goes to the Children’s Health Insurance Program, or CHIP. Marshall’s bill would flip those ratios.

“We’re just switching those two slices of the pie,” Marshall told the House Human Services Committee. He cited that funding goes to the tobacco quit line, and that cigarette smoking rates are lower than they’ve been in the past.

Supporting the bill was a spokesperson from the state Department of Justice and Rep. Jane Gillette, R-Bozeman. Gillette said she wanted to amend the bill to use some of the new 32% pot of money to pay for evaluation of how effective and efficient state health programs are.

The bill saw far more opponents however. Those who spoke against the legislation argued the funding pays for far more than the tobacco quit line and would hamper disease prevention efforts that help stop or treat early cancers tied to tobacco use.

Todd Harwell, division administrator for public health and safety at the state health department, said the bill would cut funding for tobacco use prevention and chronic disease prevention by 47%, or $4 million. The cut would hit programs that screen for breast and cervical cancer, which can be tied to smoking; as well as asthma programs; home visiting for early childhood support; and also diabetes prevention, heart disease and stroke.

Several teens from Powell County’s React Youth Coalition also testified against the bill, saying they find tremendous value in the funding for their program to help educate teens and work with their peers toward a goal of being the first tobacco-free generation in Montana.

Others who spoke against the bill included representatives for the medical field. Stacey Anderson, on behalf of the Montana Primary Care Association, said centers screened more than 51,000 people for tobacco use in 2022 and made more than 44,000 referrals for cessation and intervention.

In response to a question from a legislator, Mary LeMieux with the state health department said the state has not overspent its funding for CHIP, meaning that there’s more money in the account than is being spent on the program already. If the bill were to pass, Gillette said, that means the state could divert the $5 million it contributes to the program back to the general fund.

The House Human Services Committee did not take immediate action on the bill Friday, but a vote is expected this week in advance of a procedural deadline April 3.