As the Alabama legislature begins an uphill battle to institute a user fee (not a tax because, well, you know) on cigarette smokers that will be collected at the cash register to fund Medicaid, folks still wonder why Medicaid should get the money. From a Montgomery Advertiser reader:

Wait, HOW THE HECK do people on Medicaid afford cigarettes? They need to figure THAT out! I’m going to be pizzed if they tax me and my money goes to Medicaid after they overspent by 80 mil that’s unaccounted for!

Should it not be apparent, people with severe disease due to tobacco usually cannot work so are typically “a burden” to the healthcare system unless they conveniently die fast or are killed by fiscal conservatives on the prowl.For people who want further reason to support the user fee, let me be helpful and point out that the effects of cigarettes are not limited to that of the smoker. From a 2011 report on the Burden of Tobacco in Alabama, here is the annual burden for non-smokers:

  • 789 deaths due to secondhand smoke (SHS) and smoking-related fires
  • 1,237 years of potential life were lost by infant deaths due to maternal smoking during pregnancy in 2009
  • $83 million in medical costs due to excess morbidity and $83 million in productivity losses due to excess mortality and disability from second hand smoke.

This additional dollar would add $220,000,000 to Medicaid (and with the Federal match potentially add another half a billion) to pay for these illnesses and reduce cigarette use by 10% to prevent even more illnesses. Hope this makes a “user fee” easier to support.