If the backers of a proposed constitutional amendment get their way, however, that gap will close dramatically, and Colorado will no longer have the third-lowest taxes on tobacco products in the country -- just ahead of Kentucky and Virginia, both centers of tobacco farming.
The group, Partners for a Healthier Colorado, is asking voters to approve raising the price of a pack of cigarettes in Colorado by 64 cents, which would bring the state's tobacco tax to just above the national average. It is estimated that the additional tax would raise as much as $175 million per year, which PHC's proposal dedicates to health-care spending. But first, organizers and sponsors such as the American Cancer Society, the American Heart Association and the Colorado Health and Hospital Association must collect 68,000 signatures to get the proposal on the ballot; they plan to begin circulating petitions later this month.
"I think it has a really good chance of passing," says Barbara O'Brien, president of the Colorado Children's Campaign and a co-chair of PHC. "One thing the public cares about is health care for all kids. I think people will be very supportive."
Under the proposal, 46 percent of the funds will be earmarked to insure children and pregnant women. Today, 39 percent of low-income children in Colorado do not have health insurance -- neither private, nor publicly funded Medicaid coverage -- and 5 percent of pregnant women in the state receive virtually no prenatal care, putting their children at risk of low birth weight and serious medical complications.
"We have a high percentage of kids with no health insurance; we're one of the worst states in the nation," O'Brien says. "This will enable us to bring thousands of children into the health-care system."
Last year, Colorado was ranked last in the nation for the number of children vaccinated against diseases such as whooping cough, measles, diphtheria and polio. The Centers for Disease Control and Prevention found that only 62 percent of Colorado kids got all their vaccines, versus 75 percent nationally. As a result, a research team at Children's Hospital found that Colorado has a rate of whooping cough three times the national average, and the state has to spend more than $13 million a year treating a disease that could easily be prevented through vaccination and proper medical care.
Sixteen percent of the funds reaped from the PHC's proposed amendment would be reserved for programs that help people quit smoking. O'Brien says 34 percent of Colorado teens and 20 percent of adults smoke.
Getting teens to stop smoking is what got Albert Yates, the former president of Colorado State University and co-chair of the initiative campaign, involved. "For me, the primary reason is personal," he says. "I smoked for more than 35 years, and I lost a brother to lung cancer four years ago. We both started smoking when we were twelve. He was my best friend, and I feel I owe it to him to get the message out to young people that this is not a good path. It surprised me that the proportion of high school kids who smoke is greater than adults. We need to do something about that."
Another 16 percent of the $175 million brought in by the tax would fund the prevention and treatment of cancer and other diseases linked to smoking; 19 percent of the revenue would fund community health clinics, key providers of health care to the uninsured; 3 percent would be reserved to help local governments with health-related expenses.
There have been other proposals to increase tobacco taxes in Colorado over the years, but the last time the state raised taxes on cigarettes was in 1986. Last week, a state legislative committee defeated a proposal to boost the tax on cigarettes by fifty cents a pack. Several legislators said they didn't want to fund health care with "sin taxes" or were opposed to tax increases in general.
State representative Gayle Berry opposed the bill because most of the funds would have been used to pay for prescription drugs for seniors. "The folks proposing it didn't have a nexus to smoking cessation," she says. "If we're going to look at raising taxes, there should be a clear link to what we're taxing."
Representing grocers and convenience stores, Mary Lou Chapman, president of the Rocky Mountain Food Industry Association, testified against the bill. "We have traditionally come out against any tax on our customers," says Chapman, who is also opposing PHC's amendment. "They want to raise taxes on a small proportion of customers buying a legal product. It's a sin tax that takes advantage of the sin.
"We all assume risks in life," she continues. "We don't have an excise tax on motorcycles or snowboards, and those activities add to health-care costs in the state. Those injuries are a higher-cost type of injury."
Chapman also objects to a change in the state constitution: "I think it's a bad idea to put a tax in the constitution," she says. "We've added a lot of things to the constitution that should have been in statute."
But constitutional amendments can't be altered by the legislature, unlike statutes, and Mike Melanson, campaign manager for the initiative, says his group wants to make sure legislators can't divert the new revenue from health care. "We want the dollars to be spent as the people intend," he says.
O'Brien, however, says that if state revenues plunge, the amendment would allow the legislature to declare a fiscal emergency and use the tobacco tax revenues for any cost related to health care. And, she adds, this proposal is far different from Amendment 23, which locks in funding for K-12 education and has been criticized -- along with the Taxpayers Bill of Rights (TABOR) amendment -- for helping push the state into a fiscal meltdown.
"This is a brand-new revenue stream that doesn't take anything out of any other program," she says.
So far, the tobacco industry has been keeping a very low profile in the discussion, sending no one to testify before the state legislature about the proposed tax increase and not directly attacking the constitutional amendment. This fits a pattern seen in other states, says Melanson. Since tobacco companies are widely unpopular, they often use retail trade groups to marshal opposition to tax increases. However, around the country, the industry has recently backed off its opposition to tax hikes, even though New York reported that cigarette sales dropped by nearly half after Mayor Michael Bloomberg raised the cigarette tax and banned smoking in bars.
"They don't seem to be as out front in fighting this," Melanson says. "Their public relations are at an all-time low."
