Each year, Maine receives a significant sum of money as part of a settlement with the tobacco industry. That money, expected to total nearly $45 million this year, is intended to go toward reducing tobacco use, especially among young people, and to other public health efforts, with an emphasis on prevention.
But, many times since the settlement money started arriving in 2000, Maine lawmakers, like those in other states, have used the tobacco settlement money for other things, often to fill holes in the state’s Medicaid budget. Next, year the Medicaid payments are expected to total more than $30 million, eating up most of the $35 million the state is projected to receive from the settlement in 2021.
Since the Fund for a Healthy Maine was created in 1999, nearly $300 million meant to go toward reducing tobacco use and to support public health work has been used to fund other programs and services in Maine.
“That’s a tremendous missed opportunity for investment in the primary prevention of tobacco use, diabetes, substance use disorders and other serious chronic illnesses,” Republican Rep. Dennis Keschl of Belgrade told members of the Legislature’s Health and Human Services Committee in January.
He is the lead sponsor of LD 1961, a bill that would turn the Fund for a Healthy Maine into a trust so its funding can be better safeguarded. The bill would also create a 16-member board to determine how the tobacco settlement funds would be used in Maine.
Keschl suggested three questions to guide lawmakers’ consideration of the bill. First, is the state making the best and most appropriate use of the tobacco settlement funds? Second, how can Maine better use this special source of revenue to achieve a shared vision of health and productivity for Maine families and businesses? And, given what lawmakers and state officials know after 20 years of experience with the Fund for Healthy Maine, what would they create today to handle a $40 million per year public health settlement?
These questions offer a solid framework for consideration of this legislation.
The conditions that the tobacco settlement money were meant to address — high smoking rates and the overall health of Mainers — still need attention, and funding.
According to the federal Centers for Disease Control and Prevention, nearly 18 percent of Maine adults smoked cigarettes in 2018, the last year for which the department has data available. Each year, 2,400 adults die from smoking-related illnesses in Maine and the state has spent more than $800 million on smoking-related health care, according to the CDC.
Maine’s adult smoking rate remains above the national average, and the rate is especially high among men in Maine who did not finish high school, at more than 41 percent. Nearly a third of Maine high school students currently use e-cigarettes.
In addition, Maine faces many other public health challenges, as Sen. Linda Sanborn, D-Gorham, a cosponsor of LD 1961 noted in her testimony. Maine’s suicide rate was a third higher than the U.S. average in 2019, and 16 percent of Maine high school students seriously considered suicide in the last year. Maine had the lowest infant mortality rate in the country in 1996. Since then, the state’s infant mortality has risen and beginning in 2011 it exceeded the national average. Maine was the only state in the country with a long term increase.
Clearly, dedicating more money to public health must remain a priority in Maine. So, to Keschl’s final question, a trust fund would better ensure that the tobacco settlement funds go to their intended purpose: reducing tobacco use and proactively improving the health of Maine people.
Lawmakers should give LD 1961 serious consideration.