The idea of ratcheting up Missouri's tobacco tax looks pretty popular these days. So opponents are trying to marry the idea to a decidedly unloved notion.
Their latest radio ad fighting Proposition B, which polls show likely to win approval next week, doesn't mention tobacco or cigarettes. Rather, a man and a woman discuss how politicians inevitably divert tax money -- and presumably the ballooning revenue skimmed off cigarette sales -- to pet projects.
"Missouri can't afford any more broken promises," says one actor.
"Or," says another, "Obamacare."
The guilt-by-association tactic plays on the general dislike in Missouri for the federal Affordable Care Act. Obamacare, in fact, is the focus of another measure on Tuesday's ballot regarding health insurance exchanges. That ballot issue is broadly seen as a Republican tactic to draw conservatives to the polls by giving them a chance to vote against an element of Obamacare.
Now the anti-Proposition B camp is looking to hitch a ride on that same anti-Obamacare sentiment.
"Obamacare mandates certain tobacco prevention and cessation programs," said Ron Leone, who is running the opponents' campaign for the Missouri Petroleum Marketers & Convenience Stores Association. "A big chunk of money from the tax increase would go to tobacco prevention and cessation programs. It doesn't take a rocket scientist to see that in all likelihood, this money will end up paying for Obamacare."
Julie Sally, spokeswoman for the coalition in support of Proposition B, said that misled voters.
"The opposition's latest attack is almost as ridiculous as when tobacco companies said that smoking is good for you," Sally said.
Matthew Kuhlenbeck, program director for community health and prevention at the nonpartisan Missouri Foundation for Health, said that "there is no connection whatsoever" between the health care law and the proposed tobacco tax increase.
The back-and-forth is the latest in high-stakes battle over whether to increase Missouri's lowest-in-the nation tobacco tax. At 17 cents per pack, Missouri's tax is nearly half the next lowest in the nation and well below the $1.49 national average. In Kansas, the tax is 79 cents a pack.
Proposition B, if it wins approval, would increase the tax to 90 cents a pack and generate an estimated $283 million to $423 million a year in additional tobacco tax revenue. The new money would be put into the Health and Education Trust Fund, where 50 percent would go to primary and secondary public schools, and 30 percent to higher education.
The remaining 20 percent would go to tobacco use prevention and quit assistance programs.
The Affordable Care Act establishes a prevention trust fund, Kuhlenbeck said, and allows states, communities and nonprofit groups to apply for more than $16 billion in grants over the next 10 years. That money can be used on a range of health issues, from childhood obesity prevention to tobacco use.
Missouri already has received $80,000 from the fund to help stop-smoking efforts, including the state's toll-free Quitline.
Other areas of the federal health care law also relate to tobacco use, Kuhlenbeck said. Private insurance plans are required to cover tobacco cessation treatments, and smoking cessation coverage for pregnant women who receive Medicaid has been expanded.
"The federal health care law is focused on vulnerable populations," he said. "The new money from Proposition B is designed to be used for a much more comprehensive prevention and cessation program."
But in the radio ad, opponents of the tax increase stoke concerns that lawmakers could divert the money away from education. Some of the money, the ad contends, could "go to fund Obamacare." A similar argument is also made in a television ad.
"Obamacare is certainly a piece of our argument, but it's just one piece," Leone said.
Opponents also question whether the additional revenue will actually translate into higher funding levels for education, he said, since lawmakers have a history of using new revenue streams to justify cuts in other state appropriations.
"Our goal," Leone said, "is to educate the voter so that they make an informed decision."
The opposition's real aim is to "say and spend whatever it takes to defeat Proposition B," Sally said. "They will make all kinds of arguments to confuse and scare voters. ...They are looking out for their own profits."
The current tobacco tax brings in $95 million a year in revenue. But Sally points out that Medicaid costs associated with tobacco-related disease cost taxpayers $532 million in Missouri annually.
"Proposition B will improve health care in Missouri by reducing smoking rates among adults and keeping kids from ever starting," Sally said. "In addition, Proposition B will provide much-needed new funding for Missouri's public schools, colleges and universities."
The American Cancer Society spent hundreds of thousands of dollars to put the measure on next Tuesday's ballot, and has chipped in nearly $2 million in the last month.
The opposition campaign is largely funded by off-brand cigarette companies and convenient store chains.
A recent statewide poll conducted for The Star, the St. Louis Post Dispatch and KMOV-TV in St. Louis found Proposition B had a sizable lead -- 52 percent to 40 percent, with 8 percent undecided. An earlier poll by the Democratic-leaning Public Policy Polling found two-thirds of respondents supported raising the tobacco tax.
Leone said he still expected the vote to come down to the wire.
"I think," he said, "we are going to win or lose by a slight margin."