Hopes for a $1 tax on cigarettes may be snuffed by lawmakers who aren’t looking to spark controversy with a new tax.
But local physicians say the proposed tax could spare more cuts to the state’s funding for indigent health care and might even cut down on the number of teen smokers in the state.
Gov. Sonny Perdue’s new budget proposal for the fiscal year beginning in July includes a 2 percent cut to Medicaid reimbursements — a cut that could limit poor people’s access to health care, say two people at the helm of a well-known Gainesville clinic.
Eugene Cindea, president of the Longstreet Clinic, says fewer physicians will offer their services to Medicaid recipients if the state offers a smaller reimbursement to the doctors who treat them.
Perdue’s proposal would likely discourage doctors from seeing Medicaid recipients in their private practices — a direct result that could indirectly impact children and pregnant women, Cindea said. Children and pregnant women make up the bulk of Medicaid recipients in Georgia.
The impact in Gainesville could be significant, as more than 50 percent of the patients in some local practices have their care paid with Medicaid funds, Cindea said.
“We’d have a ... potential for a significant decrease in women that are delivering children that have decreased access to care,” said Cindea, who is a pediatrician.
“Decreased access to care relates to higher risk potential. The higher risk potential is a higher (health care) cost potential.”
Projections are the proposed additional $1 tax could raise anywhere from $340 million to $350 million in new tax revenue for the state. And while that’s not enough to fill the state’s $1 billion shortfall, Longstreet Clinic’s chief executive officer, Mimi Collins, said it could bring matching federal funding into the state if used for Medicaid.
Collins said Georgia’s 37 cent tax on cigarettes already is much lower than the national average.
“Certainly (the tax) is something that we think is very reasonable for the legislature to consider, I mean, when you have the ability match funds with federal funds, that could make a significant impact, not only in the challenges of the Medicaid budget but the overall state budget,” Collins said.
But Kerry Hicks, owner of the Clermont drive-through smoke shop the Smokin Fisherman, says more taxes are not the answer. And he isn’t convinced that another tax on cigarettes would help refill the state’s coffers.
“What happens is, as you raise these prices, people go across the state lines and they buy them other places, and (the state) ends up losing more money than they’re getting now in state taxes,” he said. “... I just don’t think that you can use cigarette taxes to pay for health care. They’re not doing to alcohol, why are they doing it to cigarette people?”
Hicks said many people who smoke are in the lower- and middle-income brackets.
“They’re already taxed enough as it is,” Hicks said.
Hicks said state lawmakers should begin looking at shrinking the size of government before adding new taxes to his customers. And State Rep. Doug Collins, R-Gainesville, said that is exactly what might happen.
Collins said a bill that would create the additional tax is out there, but it likely will not go anywhere. House Bill 39, sponsored by Savannah Republican Ron Stephens, was introduced into the state House of Representatives last February.
“I think ... a lot of the legislators feel like raising taxes really of any kind right now is probably not the best idea,” Collins said. “There are some issues with the tax.”
Collins points out that Medicaid is not the only fund affected by the recent economic downturn and that lawmakers are having to downsize state government to balance the budget.
“I think right now all things are being considered, and right now we’re trying to piece together what is the best budget we can to fulfill the core functions of the state,” Collins said. “Are all of the departments and all of the folks who have funding from the state being affected by this? The answer is yes. Everybody is taking rather large cuts to balance the budget.”
But that’s not to say he is not concerned about Medicaid. He said lawmakers are doing everything they can to make sure doctors who participate in Medicaid are paid promptly and fairly.
“My concern is that program. That is one of the reasons I’m fighting hard to minimize the impact (the budget) would have in our medical communities, because we do need the access, and doctors are not forced to take Medicaid patients,” Collins said. “That’s a choice that they make in their practice, and I appreciate them making that commitment. And I think the position of the House, and the legislature in general, is to do the best we can to help in those areas.”
But he’s not sure exactly how that aid will come.
“What will happen is still up in the air.”
State Reps. James Mills, R-Chestnut Mountain, and Carl Rogers, R-Gainesville, did not return phone calls seeking comment for this story.