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Maine Health Advocates Seek to Restore Smoking Cessation Funds
11/19/2012   Reported By: Patty B. Wight

When Maine balanced its budget this year, one of the cuts was to smoking cessation services for MaineCare recipients. The cut, which went into effect Sept. 1, eliminated $500,000 from the budget for the programs, resulting in the loss of about $1 million in federal matching funds. Now, a coalition of public health organizations is hoping to restore the services, which they say will save Maine money in the long run. Patty Wight reports.

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When Dr. Lani Graham - co-chair of the public health committee for the Maine Medical Association - heard about the cuts to smoking cessation programs - she was shocked. Shocked because, she says, tobacco is a leading cause of death and disease in the U.S. and Maine.

And as it is, Graham says, tobacco addiction doesn't get adequate resources and attention like other diseases do. "If I were a smoker, which, thank God I'm not, I would be just enraged at the fact that I wouldn't have access to services," she says.

Part of the problem, says Dr. Graham, is that tobacco use is seen as a choice. But Graham says that choice is often made in the teen years, and by the time someone is hooked, it's one of the toughest addictions to beat - on par with cocaine and heroin.

The upside is that if someone receives help to combat the addiction, the chances of quitting double.

"We should be doing everything we possibly can to try to help people in the MaineCare program quit," says Edward Miller, vice president of policy for the Northeast American Lung Association. Miller says stopping tobacco addiction is the most cost-effective step Maine can take to keep health care costs down.

His assertion is backed up by a study published earlier this year by George Washington University. It examined the Medicaid smoking cessation program in Massachusetts and found that for every $1 spent, there were more than $3 in associated medical savings.

"And over 40 percent of people in the MaineCare program are smokers, so this is a major problem," Miller says. "And we really should be doing the opposite of what was done last session."

The cuts were made last session to help balance the state budget. One argument for making the cuts was that there are other smoking cessation services available in the state - namely, a telephone service.

Audio from voicemail: "Thank you for calling the Maine Tobacco Helpline. If you are a first time caller, please press '1' now."

Hilary Schneider of the Maine Cancer Society says the problem is the Tobacco Helpline can only provide coverage for over-the-counter nicotine replacement drugs. Oftentimes, she says, prescription drugs are needed to conquer such a powerful addiction.

"And we also know the Helpline has a limited budget, and time will only tell, whether the Helpline, even for over-the-counter cessation productus, can handle that additional population."

Schneider says the loss of nearly $1 million in federal matching funds could also put the state in a pinch. Director of MaineCare Services Stefanie Nadeau says the cut was a tough, but necessary, choice.

"One thing that needs to be taken into consideration is, through the Affordable Care Act, effective January 1 of 2014, these services and these prescriptions do come back as mandatory benefits under the Medicaid program," she says. "So we will be required to restore smoking cessation products."

"That really is not something that we ought to just count on," says Ed Miller of the lung association, "Really, no details have been released on what does that mean, how many medications may be covered, will all of them be covered, for how long? There are a lot of questions still on that."

Miller says Maine used to be a leader in smoking cessation programs and that he'd like to see the cuts restored by July. He says that could happen in a variety of ways that would be budget-neutral. One way, he says, would be is to close a loophole that taxes tobacco products other than cigarettes at a much lower rate.


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