It was a wild and weird election that turned a lot of expectations on their heads. But two Missouri ballot initiatives with healthcare implications were a real head-scratcher.
On one side: the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association and the Campaign for Tobacco-Free Kids firmly aligned against new tobacco taxes.
On the other side: Big Tobacco and Vote Yes On Three For Kids. Amendment 3 proposed adding 60 cents to Missouri's 17-cent-per-pack tobacco tax, phased in through 2020. The estimated $300 million generated annually would have gone to early childhood education.
Then there was the competing Proposition A, supported by smaller tobacco companies; it proposed raising the tobacco tax 23 cents phased in through 2021. The approximately $100 million generated annually would gone toward transportation projects.
Puzzled why tobacco companies would support any kind of cigarette tax increases, spending nearly $18.5 million combined to pass one or the other of the measures? It all comes down to the marketplace pressures.
A provision of Amendment 3 would have hurt Big Tobacco's smaller rivals by imposing an additional 67-cent-per-pack tax—on top of the 60-cent hike imposed on the major brands—on discount cigarette brands left out of a 1998 tobacco lawsuit settlement. In the settlement, the major tobacco companies agreed to pay at least $206 billion over 25 years to 46 states for healthcare costs related to tobacco. As a result, major tobacco firms pay millions annually to Missouri, but their smaller competitors don't.
Smaller tobacco companies, not surprisingly, opposed Amendment 3.
Healthcare advocacy groups said neither tax was big enough. A tax increase “has to be significant enough to make consumers pause and think maybe it is really time for me to quit,” said Karen Englert, government relations director in Missouri of the American Heart Association. The amendment also prohibited funding for “tobacco-related research of any kind.”
In the end, Missouri voters rejected both, leaving the state with a tax that's the lowest in the nation and well below the national average of $1.65 per pack.
