SPRINGFIELD NEWS-LEADER

Published October 15, 2006

Leave tax hike out of constitution

Springfield physician Jim Blaine makes a strong argument in favor of a tobacco tax increase.

The current tax is among the lowest in the nation.

Increasing the tax is likely to reduce tobacco use among young people.

- More health care funding, particularly in the Medicaid program, is good for Missouri.

So why are we against Amendment 3, the proposal to raise the tobacco tax by more than 400 percent?

Because Blaine is making his arguments to the wrong people.

Passing Amendment 3 would add a huge tax increase into our state's constitution. It would change our state's health policy and tie legislators' hands as they remake the Medicaid program. It would take responsibility out of the very body that should be discussing these issues. We believe that tax increases and health care spending are matters for legislators and that Missouri's Constitution should remain a broad document that guides our state on bigger issues.

That's why we urge a no vote on Amendment 3.

Change in policy

We realize that this position is a change from past editorials on this topic. As recently as February, we wrote in favor of this tax. But since then, we've been convinced that while some of the elements of this tax proposal are worth supporting, writing such a tax increase with detailed health care funding mechanisms into the constitution is the wrong way to go.

A year ago, when we suggested that a new tobacco tax be placed on the ballot, we decried the fact that the 2002 tobacco increase that failed didn't put enough of the revenue toward tobacco cessation.

Unfortunately, the supporters of Amendment 3 have committed the same sin. Less than 20 percent of the revenue that would be generated by the 80-cent-per-pack tax increase would be specifically dedicated to tobacco-prevention efforts. While the amount of money spent on tobacco-related illnesses would be significant because of the sheer size of the tax increase, the majority of the increase would still go directly to hospitals and health-care interests.

We don't deny that Medicaid funding is too low. In fact, we agree with the basic premise of increasing reimbursement to doctors and hospitals that provide Medicaid services. The problem is that it should not be written into the constitution and thus create an earmark that overrides any specific action the legislature might take up in future sessions.

In the same way, we'd like to see tobacco taxes increase, but only if the money generated goes specifically to tobacco-prevention programs, and only if such decisions are made through the legislative budgeting process.

Overwhelming opposition

Perhaps this is why such a growing bipartisan group of legislators are against Amendment 3. When's the last time Gov. Matt Blunt and Attorney General Jay Nixon agreed on anything? Throw in Senate President Pro Tem Michael Gibbons, House Speaker Rod Jetton, Minority Leader Jeff Harris and most of Springfield's legislative delegation, and you get a clear idea that legislators think this is a bad idea.

Why? One of their top priorities in 2007 will be revamping the Medicaid system. If the constitution already has been rewritten to require certain forms of spending at specific levels — as Amendment 3 does — their hands will be tied.

The process of creating specific legislative earmarks makes it difficult for legislators to balance the budget and adapt to changing economic times.

While legislators should be criticized for not properly spending the tobacco settlement money on tobacco cessation programs, for instance, the solution isn't to write into the constitution a spending solution, but to hold legislators accountable by kicking them out of office for not doing their jobs.

If we turn to the constitution as a way of bypassing the legislature, then we'll soon be on a path to making the General Assembly obsolete, and legislators will rarely make any decisions. Unfortunately that's a growing trend nationwide. This year, 18 states will vote on 76 ballot initiatives in November, according to the National Conference of State Legislatures. Such a number has been exceeded in a non-presidential election year only once, all the way back in 1914.

We believe that's a bad trend.

Going forward

So what should be done about tobacco use among young people?

First of all, we're not sure that more government spending is the key. The annual Youth Risk Behavior Survey showed that the percentage of Missouri youth who smoke is dropping at a much faster rate than the national average even though the state has one of the most paltry anti-smoking budgets in the nation. The evidence suggests more money won't make that much of a difference.

But even the Missouri Petroleum and Marketers & Convenience Store Association, the group that has successfully fought tobacco tax hikes in the past, is willing to compromise on an increased tax as long as the money raised goes specifically to tobacco-related health programs.

"I offered a 100 percent tax increase," says MPCA executive director Ron Leone. "I didn't even get a response."

The unwillingness of the health care community to compromise with the business community is why Amendment 3 has ended up on the ballot instead of in the legislature where it belongs.

We believe most Missourians would support a reasonable tax hike on tobacco products. We believe the legislature ought to debate and pass such an increase and apply the revenue to tobacco-related health care expenses as part of comprehensive Medicaid reform.

But writing such language into the Missouri Constitution would be short-sighted, at best.