Topeka — Higher tobacco taxes and a statewide smoking ban are among a state board's top priorities in drafting health care reform initiatives.

The Kansas Health Policy Authority board's members said Monday that a tax increase would raise $52 million a year for health care initiatives and discourage smoking. The board supports raising the cigarette tax by 50 cents a pack, to $1.29.

They also said a ban on smoking in public places would improve public health and promote preventive health care. State law now leaves decisions about banning smoking in bars, restaurants, other businesses and other public buildings to cities and counties.

Recommendations

The board is drafting recommendations for legislators to consider next year and plans to issue a report Nov. 1 outlining policy options. The state created the authority in 2005 to review health care issues and administer some state programs; the board sets policy.

Its options for legislators already include mandating health coverage for children and young adults and expanding subsidies approved this year to help families with modest incomes buy insurance. But the board focused Monday on promoting preventive care and individuals taking responsibility for their health.

"My top priority would be the tobacco tax," said board member Joe Tilghman, of Overland Park, a retired regional federal health care administrator. "This is the only one we've got to provide revenue."

Public health advocates have repeatedly pushed legislators to increase tobacco taxes because of the link between tobacco use and major health problems. They also strongly support a ban on smoking on public places.

'Not excited about it'

Gov. Kathleen Sebelius proposed a tobacco tax increase three years ago to raise money for health programs, but legislators ignored her proposal. Legislators considered a smoking ban this year, but a bill stalled in the Senate because of opposition from business owners.

House Speaker Melvin Neufeld said while some legislators remain skeptical of a smoking ban, it will be difficult for others to oppose it if their cities have imposed restrictions.

As for a tobacco tax increase, Neufeld, an Ingalls Republican, said: "I'm not excited about it, but we'll let them talk about it."

But Marcia Nielsen, the authority's executive director, said attacking tobacco use is important to any health care program.

"If, in fact, you're serious about health reform - improving people's health - you've got to focus on the fact that tobacco is the leading killer, preventable death, in the state of Kansas and across the nation," she said.

Health insurance

A health care bill legislators approved earlier this year directed the Health Policy Authority board to study initiatives for making sure more Kansans can afford good health services. The same bill established a program that, starting in 2009, will give poor Kansans about $3,200 a year for health insurance.

About 312,000 Kansans don't have health coverage, making it more difficult for them to obtain good care.

But the board's goals are broader than making insurance more affordable. It wants consumers to have better information so they can make informed decisions about their care, and it wants to give doctors, clinics and hospitals financial incentives to emphasize preventive care, Nielsen said.

For example, board members said another high priority will be studying how doctors and other health care providers are paid, starting with state programs covering services for the needy. The state and private insurers pay doctors more for surgeries and other medical procedures than they do for preventive care, they said.

And they want to move each Kansan toward choosing a medical "home," where they would receive comprehensive health services, focusing on preventive care first.

In addition, board members said they want to encourage schools to collect information about students' fitness, promote healthy eating and strengthen their physical education programs.

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