AUGUSTA — The sponsor of a bill that would have prevented smokers from receiving MaineCare benefits amended the legislation Tuesday to focus on smoking cessation programs.
The change by Sen. Thomas Saviello, R-Franklin, disarmed more than a half-dozen opponents who planned to testify against the legislation because they believed it was illegal and discriminatory.
The latter charge was debated during a public hearing. However, the illegality of the original proposal appeared to be the impetus for Saviello's change in direction.
Saviello told the Health and Human Services Committee that he'd been advised that his proposal was unconstitutional because the government cannot dictate behavior or deny clients of MaineCare — the state's Medicaid program — from receiving benefits.
Saviello said he originally submitted the legislation because a constituent who worked in a health facility was tired of treating MaineCare patients with respiratory illnesses who continued to smoke.
Saviello said he thought the proposal was akin to forcing smokers who visit his house to smoke outside. Since MaineCare is taxpayer-funded, he said, he believed smokers receiving benefits should submit to taxpayer rules.
Sen. Margaret Craven, D-Androscoggin, said the original proposal discriminated against poor people. When Saviello said that he was simply trying to advocate smart choices for individuals, Craven noted his opposition to the state's mandatory seat-belt law.
"It just seems contradictory," she said.
"It's my choice to put a seat belt on," Saviello said. "And I'm not on MaineCare."
Ana Hicks of Maine Equal Justice Partners said that if Saviello's original bill had passed, it would have affected the majority of MaineCare recipients.
According to the Maine Public Health Association, more than 41 percent of MaineCare recipients are smokers, nearly twice the rate of the general public.
Hicks said federal Medicaid law does not permit states to impose eligibility conditions that would deny benefits for smokers.
Hicks spoke in favor of Saviello's amended bill, which would focus on ways to reduce smoking among MaineCare recipients.
"The best way to help people to stop smoking and improve their health is by continuing to provide them with MaineCare and helping them to access effective tobacco cessation treatment, not to threaten to cut them off of health coverage," Hicks said.
Saviello recently told the Sun Journal he wasn't sure his bill was legal, but he wanted to start a dialogue. He reiterated that statement Tuesday.
"I'm not anti-smoker, although I've been called that by some people," he said.
His amended bill is supported by the American Lung Association, the Maine Public Health Association, Maine Equal Justice Partners and the School of Social Work at the University of Maine.
Each had planned to oppose the original draft.
The bill's goal to reduce smoking among MaineCare recipients would be coordinated by several agencies, including the Maine Center for Disease Control and Prevention and the Partnership for a Tobacco-Free Maine. The groups would develop an awareness campaign designed to use MaineCare's existing tobacco treatment benefit.
Progress would be reported to the Health and Human Services Committee on Nov. 31, with annual updates through 2014.
A work session will be held at 9 a.m. Friday on Saviello's bill.