We just checked our DNA tests, we’re 100% ready for warm weather and the chance to go soak in some Vitamin D and outdoor activity (can we livestream committee hearings from the Monon?). But the beginning of spring also brings some sobering anniversaries from 2020: Indiana’s first COVID death and statewide emergency orders announced last March 16th, followed by a full year of tragedy, turmoil, and unprecedented efforts to prevent greater loss of life and livelihoods.
Living through the last twelve months together has certainly emphasized the importance of health – from our own daily habits to the need for more proactive public policies as a state.
COVID is still very much with us, but as case counts decline and vaccinations rise there are some long-awaited glimmers of light at the end of our dark path through the pandemic. But here’s the question: Will we remember the tough lessons of the past year – how many Hoosiers struggle with chronic ailments and pre-existing conditions, how vulnerable many of our communities are to a crisis, and how strong the connection is between public health and a productive economy?
Will we keep working on our fitness as a state, making a post-COVID commitment to a healthier Indiana?
A 50 Cent track appropriate for the 50 cent per pack cigarette tax increase proposed in the House budget (HB1001). We’ve been patiently pushing to raise Indiana’s lowest-in-the-Midwest tax for several sessions, to reduce Indiana’s high smoking rate while paying for critical public health investments.
We’ve been part of a coalition of business and health organizations advocating for a much larger hike, $2 per pack, to more dramatically discourage smoking for a healthier workforce and more productive economy, and a larger windfall to focus on priorities like healthy food access along with ongoing healthcare costs (recognizing that revenues decline over time with fewer smokers).
So there are two ways to look at the House plan:
- Settle for the 50 cent proposal as a step in the right direction that will help cover a growing Medicaid budget as we recover from COVID (noting as tobacco use is also a driver of Medicaid costs, as nearly half of all adult enrollees in Indiana are smokers);
- Or take a more pessimistic view: The 50 cent increase probably closes the door on revisiting the issue in the near future, leaving us stuck closer to the status quo with the costs of too many smokers weighing down our economy – time and productivity lost to tobacco-related illnesses, higher healthcare expenses that could be dedicated to other business investment, and less money in the general fund.
We’re reserving judgment for now, as the Senate takes its turn remixing the two-year, $36+ billion budget bill…but we’ll continue to make the case for a bigger cigarette tax increase, commensurate with the scale of smoking’s economic damage and the scope of our other healthcare challenges.
So far, the diagnosis on other public health priorities before the General Assembly is mixed:
- The budget also includes $50 million for the Hoosier Health grant program proposed in HB1007, now in the Senate for consideration – we support the bill, but…
- Biennial grant programs aren’t a substitute for sustainable, long-term funding for public health, and the current budget also reduces funding for mental health and substance abuse treatment by $26 million;
- The Senate did pass HB1203 out of committee Wednesday, which (among other provisions) extends local authority to enact clean needle exchange programs through 2030, to avoid compounding the related health issues spawned by drug abuse without such programs;
- Amid all the International Women’s Day posts on Wednesday, the General Assembly missed the chance for meaningful workplace protections for expectant mothers – but SB10 (a statewide maternal mortality review committee) did pass committee on its way to the House floor.
Connecting the Dots:
Public health isn’t just a narrow area of policy prescriptions; it’s a priority that has some implications for most of what government does (and doesn’t do).
Take transportation, for example. Accessible public transit helps residents of underserved neighborhoods get to doctor’s appointments and shop for healthy food (especially pertinent here in Indianapolis, where food deserts still cover large areas of our urban core). There’s a solid body of research on ways transit benefits health, from increased physical activity and less stressful commutes to reducing air pollution and its byproducts (e.g. urban ‘heat islands’).
So in case you thought we’d take a week off from pointing out how destructive SB141 is, never fear – add health to its (long) list of negative consequences. (We’re still waiting, but hear the bill may get a hearing in Roads & Transportation on March 24th.)
Public resources for mental health and substance abuse issues also affect issues like homelessness, that require comprehensive solutions. SB218 was held in committee this week – it emphasizes countywide collaboration and resource-sharing among township trustees extending poor relief to the homeless.
This week also saw starts and stops on a few education issues:
- SB54 passed the House Education Committee, with significant changes – what started as a mandate for students to complete the FAFSA before graduation (to better understand and hopefully take advantage of financial aid opportunities for post-secondary education and training) turned into a grant program to encourage districts – with some emphasis on high-poverty schools – to improve their FAFSA completion rate;
- The Education Committee also held SB358, which potentially expands the ability of charter schools to seek transfers of vacant or underutilized buildings from traditional school corporations (the so-called “dollar law”).
We’re also in wait-and-see mode on SB358; we support more flexibility for districts like IPS to seek redevelopment opportunities for properties to overcome budget challenges and drive more dollars to the classroom. However, limiting the dollar law should come with a commitment from IPS to share revenues equitably with innovation network schools and continue pursuing operational efficiencies.
IPS and other urban school districts have to work smarter because they face some fiscal disadvantages in the school funding formula (which we detailed in last week’s update). The Senate K-12 Funding Committee meeting scheduled for Thursday afternoon was cancelled, so not much to report there.
We continue to support more complexity funding for students in poverty. Boosting special education and English Language Learner funding would also ease the budget constraints on schools that serve more at-risk students.
There’s plenty of controversy around K-12 funding issues; not so much on HB1006, the bipartisan police reform bill that continues to speed through the legislative process. The bill passed Senate Corrections and Criminal Code, was recommitted to Appropriations (due to its fiscal impact) and passed there too, becoming eligible for floor action.
We see no reason for this plan to slow down or get pulled over. It shows that thoughtful policymaking that engages interested parties and builds consensus around meaningful solutions can still happen.