January 8, 2013 -- Governor Kitzhaber’s proposed healthcare budget taps $120 million from the Tobacco Master Settlement Agreement as a revenue source for the Oregon Health Plan, but doesn’t indicate how those dollars should be spent. Rep. Mitch Greenlick (D-Portland) would like to convince the Oregon Health Authority, which will appropriate that revenue, to distribute 10 percent -- $12 million -- to the coordinated care organizations and earmarked for tobacco prevention and reduction.
“The Tobacco Master Settlement Agreement had two functions,” Greenlick told The Lund Report. “To reimburse the state for tobacco related healthcare costs and to prevent and reduce tobacco use. This (giving a portion of the Tobacco MSA funds to CCOs for tobacco prevention) puts the two things together.”
When the House Healthcare Committee met last month, Greenlick shared his idea with Dr. Bruce Goldberg, director of the Oregon Health Authority. Later, Greenlick said Goldberg was non-committal in his response.
A survey conducted in 2011 found that 31 percent of people on the Oregon Health Plan are smokers, roughly 201,000 Oregonians – twice the rate of the general public, which had a 15 percent smoking rate.
“Directing that money toward CCOs (for tobacco reduction and prevention) will target a population that needs it the most,” Greenlick said.
In November, a coalition of leading public health and healthcare organizations also recommended using 10 percent of the Tobacco MSA funds for tobacco prevention. While the coalition urged that a majority of the Tobacco MSA funds (60 percent) go to “equip Community Care Organizations for success and achieve greater health transformation through community-based health initiatives,” it also recommended that 10 percent of the Tobacco MSA be dedicated toward the Tobacco Prevention and Education Program which reaches the entire population, not just those on OHP.
“We commend Rep. Greenlick for his commitment to tobacco prevention and his work to dedicate Tobacco Master Settlement Agreement (TMSA) funds toward tobacco prevention,” said Stephanie Tama-Sweet, director of government relations for the American Heart Association. “The purpose of the TMSA was to help compensate states for the cost of tobacco use and chronic diseases. We remain committed to this original intent and will continue to urge legislators to dedicate TMSA funds towards their intended purpose of tobacco prevention.”
For his part, Greenlick isn’t about to give up. “I’m very serious about it,” he said. “I’ll be taking it up with the Oregon Health Authority.”
The CCOs will be held accountable to reducing the tobacco rate, Tama-Sweet pointed out, but haven’t been given the resources or guidance on how to accomplish this.
“Having a CCO measure on tobacco is an important step but it’s not the equivalent of funding tobacco prevention on a statewide or CCO level,” she explained. “We urge the agency (OHA) and legislature to respond to Rep. Greenlick’s questions and dedicate funds towards the Tobacco Prevention and Education Program.”
“Tobacco cessation is a critical piece of what coordinated care organizations will be doing,” according to Alissa Robbins, spokesperson with the Oregon Health Authority. “Some of the dollars going to CCOs will be used for these activities. We’re also open to exploring different funding options as we work to achieve better health outcomes.”
FOR MORE INFORMATION
Prior Lund Report coverage of the Tobacco Master Settlement agreement:
Coalition Announces Health and Prevention Policy Package
Oregon Health Plan Members Still Puffing Away
Government documents:
Gov. Kitzhaber's budget presentation to the Oregon Health Authority (PDF)
Gov. Kitzhaber's complete draft budget
Image for this story by Kevin Wash (CC BY-NC-ND 2.0) via Flickr.
