June 22, 2018
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Maine shortsighted to end funding for smoking prevention

By Dr. Lani Graham, Special to the BDN

The state last month eliminated smoking cessation treatment for nearly all Medicaid, or MaineCare, patients despite overwhelming evidence that it saves lives and money. At a time when most states are working to help smokers quit, Maine is going against the tide. Maine now has the dubious distinction of joining Alabama and Georgia as one of only three states to not cover all Medicaid patients for smoking cessation medications.

Eliminating the treatments is sure to have financial consequences the administration will feel for years to come, to say nothing about the thousands of Maine people who are likely to experience the long-term health consequences of tobacco use.

Nearly a quarter of a million Mainers smoke. Unfortunately, those who receive MaineCare are nearly twice as likely to smoke than the general population. According to the CDC, 10.6 percent of MaineCare health care expenditures — equivalent to $216 million — are attributed to tobacco use. Put a face to those numbers, and it means a mother, a father, a friend or a child getting sick with cancer or another tobacco-related (and preventable) illness.

People who have health coverage for cessation services are more likely to quit smoking successfully. Two recent studies point to the cost savings associated with smoking cessation benefits. A study conducted out of George Washington University found that for our neighbor, Massachusetts, every dollar spent on anti-smoking programs for low income people saved $3 in medical costs. Extrapolate those results to Maine, and we are sure to see significant savings.

In fact, a study done by Penn State researchers found that when you add direct health care expenditures, workplace productivity losses and premature death, smoking costs Maine more than a billion and a half dollars every year. Put another way: while the average retail price of a pack of cigarettes in Maine is $6.46, the real price to society and to the state’s economy is more than $26 per pack. The state could surely find other uses for that money.

As state officials and lawmakers look for ways to save money, they should consider that, according to the same study, funding smoking cessation treatments can save Maine more than $5 million every year. That happens to be almost the total amount of savings the recently created MaineCare Redesign Taskforce is trying to find in the MaineCare program. But, as anyone who works in medicine can tell you, the hardest “sell” is prevention. Ironically, it is much easier to obtain money for a fancy new machine for treatment of some illness than it is to invest money to prevent the illness in the first place.

The LePage administration has made its mark. Undoing the damage before patients and the state feel the full impact of its decision is the right — and fiscally smart — thing to do.

Dr. Lani Graham is a family physician and the co-chairman of the Maine Medical Association Public Health Committee. She is the former director of the Maine Bureau of Health (now the Maine Center for Disease Control and Prevention).

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