Prevention is as popular as puppies and rainbows.
The idea of investing in health now to save money and lives later is mainstream and bipartisan. United States Sen. Richard Burr has even attacked federal health care reform by spuriously claiming that it does not put enough money in prevention.
Despite the savings that come from reducing the incidence of disease the most recent session of the General Assembly threw an anchor around our state’s prevention efforts and tried to sink them in one baleful budget.
New Republican majorities in the House and Senate entered the session radically opposed to maintaining or raising revenue to bolster needed services during the recession.
Legislators chose, for example, to keep the tobacco tax in North Carolina at a paltry 45 cents per pack. That is the 6th lowest tobacco tax in the nation. South Carolina and Mississippi now have higher cigarette taxes than North Carolina. And no one could claim that our Confederate confederates are hyper-taxed.
A tobacco tax would have raised money to preserve important health programs, it would have reduced teen smoking rates, and it would have saved money in Medicaid as fewer people suffered the ill effects of sucking down nicotine.
Leaving the tobacco tax unchanged was passive but the General Assembly also took many actions to undermine the health of our state. The new state budget, for example, cleans out the Health and Wellness Trust Fund (HWTF).
This trust was established from money coming from the state lawsuits against the tobacco industry. A portion of the legal settlement goes to the HWTF each year, which in turn, supports an array of prevention efforts.
Republican budget writers raided the existing money in the trust and diverted new monies flowing into the fund. That means that the HWTF is effectively dismantled. The work by Trust Fund grantees on prevention, on reducing obesity rates, on eliminating racial health disparities, on providing prescription assistance, and on reducing teen smoking now have no dedicated source of funding.
Maybe future legislatures will support some of these programs, or maybe not.
Leaving North Carolina at the bottom of tobacco tax rates and axing the Health and Wellness Trust Fund were bad, but nothing was as deceitful as the attack on Planned Parenthood this legislative session.
In the budget lawmakers included a provision that bans Planned Parenthood from competing for state and some federal grants to provide prevention services. This is not about abortion or saving state funds. In fact, we don’t know what it’s about. Republican legislators said the provision is not about abortion but declined to explain the unprecedented move.
Blocking Planned Parenthood from competing for grants does not help balance the budget. What it does is hurt teen pregnancy prevention programs and prenatal care for underserved women. Without grant funding cities like Fayetteville will lose pregnancy prevention outreach efforts. And for many women Planned Parenthood is the only health care alternative to the county health department. Local health departments are overwhelmed by the current demand for services. At some county health departments the average wait time for new patients is several months. And health departments are not open late or on weekends.
Planned Parenthood is critical to adequate health care access for women with no place else to go.
With Republicans controlling the state legislature for the first time since Reconstruction everyone expected some changes. Serious budget cuts were also foreseeable.
But eviscerating preventive health care services, even when it doesn’t save the state money, is inexplicable. An attack on apple pie can’t be far behind.
Adam Linker is a Policy Analyst at the North Carolina Health Access Coalition.