October 31, 2005

Missouri Tobacco Excise Tax Increase Initiative

Although Missouri is one of the highest states in per capita use of tobacco, we currently spend the least on tobacco prevention and have the second lowest tobacco tax in the nation. Health care and disability costs, according to the Centers for Disease Control and Prevention (CDC), add up to $7.18 for every pack smoked. This translates to $800 for every man, woman and child in the state every year.

The American Heart Association, the American Cancer Society, the American Lung Association, the Missouri Hospital Association, the Missouri State Medical Association (MSMA) and over 30 non-profit organizations are supporting an initiative petition effort that would raise the Missouri tobacco excise tax by constitutional amendment in
November 2006.

The measure would add an additional 80 cents per pack to the current 17 cents state excise tax on cigarettes, increase other tobacco products by 20% and result in approximately 351 million dollars per year in revenue.

The money will be deposited in the Healthy Future Trust Fund under the direction of the director of the Department of Revenue. The revenue will be allocated as follows:

Tobacco Use Prevention, Education & Cessation - 17 1/2% (62 million) administered by the Department of Health and Senior Services, the Department of Mental Health and the Department of Public Safety. An oversight committee will be formed and follow the guidelines of the CDC Best Practices.

Chronic Disease Management - 28.5 percent Health Access Cards given to indigent patients with a household income of 200 percent or less of the poverty level with special emphasis on management of tobacco related diseases as administered by the department of social services.

Health Care Access and Treatment - 54 percent

1. Primary care and specialist physician access by Medicaid patients to be paid on Medicare schedule and administered by the Department of Social Services - 54 percent of this section.
2. Trauma Center and Emergency Room resources to compensate for Medicaid patients and uninsured Missourians - 20 percent of this section.
3. Safety Net Clinics compensation for service to patients that are 200 percent or less of the poverty level and administered by the department of social services - 20 percent of this section.
4. Emergency Ambulance Care for Medicaid patients - 2 percent of this section.
5. Prevention of the Incidence and Severity of traumatic injuries - 1 percent of this section.

This ballot initiative revenue will be more likely to be spent as intended because it is constitutional rather than statutory. The $62 million it will provide annually for tobacco prevention will bring Missouri from the lowest to among the highest in dollars spent to combat tobacco use. The remainder of the revenue will be utilized for health care access for indigent patients. The MSMA Public Affairs Commission would love to have your support for this important
initiative; please call the MSMA at (573) 636-5151 for more information.

Jim Blaine, MD, chair
MSMA Public Affairs Commission

[top of page]