Governor Gets Bill on Tobacco; $17.5 Million for O.C. Health Care

Ten months after passage of Proposition 99, the anti-smoking tobacco tax initiative, the Senate and Assembly on Thursday sent Gov. George Deukmejian a $1.5-billion bill implementing the measure on back-to-back lopsided votes.

The legislation would provide about $17.5 million from the cigarette tax to help pay Orange County hospitals and doctors for emergency medical services given to the poor without reimbursement. County hospitals estimate that they have provided more than $200 million in such uncompensated care.

But county officials said Thursday that they hope some of the money can be used to increase the level of health care available to the poor. One possibility, for example, is granting more money to the county’s ailing trauma centers, they said.

At Fountain Valley Regional Hospital and Medical Center, which closed its trauma center last week, administrators said Thursday that their decision could be reconsidered if enough money is available.

Richard E. Butler, a vice president at the hospital, said it would take $3 million for the trauma center to break even. “If the factors change so that the money makes a different picture for us, we’ll reconsider” the center’s closure, he said.

Lobbyists and Officials Cheer in Hall

In Sacramento, lobbyists and officials from counties, medical groups and other health groups that backed Proposition 99 whooped and cheered in the hall outside the Assembly chamber moments after the measure won final legislative approval on a 68-2 vote. Earlier, the Senate had approved the Proposition 99 implementation bill by a 38-0 vote.

Deukmejian is expected to sign the bill.

The impromptu celebration by health advocates allowed a release of tension that had built up during weeks of intense bargaining by lawmakers and a threat to the bill posed by a last-minute lobbying effort by the tobacco industry. The lobbying effort keyed on a provision of the bill that directs $28.6 million over two years into an anti-smoking TV print ad campaign aimed at California’s youth.

Tobacco companies, said to be fearful that a TV ad campaign would persuade more Californians to give up smoking, hoped to delete the provision from the bill. They won some allies in the Legislature, including Senate Republican Leader Ken Maddy of Fresno, who said he opposed using any of the money for TV ads because he did not think mass advertising was the best way to reach smokers.

Maddy, who had dropped his objections Wednesday, carried the bill on the Senate floor. He said many compromises were made by lawmakers. But he said the overall benefits of the bill overrode objections to individual parts.

“When you have $1.5 billion to give away you usually can find room for accommodations,” he said.

The $1.5 billion contained in the bill represents 2 1/2 years worth of money raised by the tobacco tax increases mandated by Proposition 99. The measure caused cigarette taxes to go up 25 cents a pack and resulted in comparable increases to other tobacco products, such as cigars. The initiative directed that most of the money be used to pay for health programs for the poor.

Some of the money received from the tax will be sent directly to hospitals, according to a formula based on each facility’s uncompensated care burden. But at least $10 million of Orange County’s share will be distributed for health services by the Board of Supervisors.

Board of Supervisors Chairman Thomas F. Riley said he would like to see some of the money go to help trauma centers.

“I think the trauma-center system saves lives,” Riley said. “The proof positive is there. Trauma centers should be part of the goal.”

State Sen. Marian Bergeson (R-Newport Beach) has coordinated a committee in the county that examines health services for the poor. That committee might consider how the money could best be distributed.

Committee member and Supervisor Gaddi H. Vasquez said: “The committee is going to have an opportunity to exchange ideas and concerns at a level that we’ve never done before. It might open up some areas for financing.”

Vicki Mayester, a health care advocate for the poor, expressed concern over whether the indigent will actually benefit from the extra money.

“I think it’s important money,” Mayester said, “(but) I guess I wonder whether it will translate into more accessible services for people. I’m sorry there isn’t something written into the bill.”