By ANDY MARSO
Public health advocates are cheering proposed changes to the state tax code that would encourage healthy behaviors. But Gov. Sam Brownback and the legislators who pitched them face challenges in getting them passed.

As part of a larger effort to fill a gaping budget hole, Brownback called for increasing taxes on tobacco and alcohol. The tobacco tax in particular has gathered support from the state’s health community.

But the pushback from industry and business groups — including convenience and retail liquor stores — has been swift, and legislative leaders who campaigned on their conservative credentials have objected to the tax increases.

Meanwhile, two legislators have introduced a bill to exempt fresh fruit and vegetables from the state sales tax, but that proposal is likely to run into the opposite problem: The state desperately needs the tax money.

“We’re not under any illusions it will be easy,” said Sen. Michael O’Donnell, a Republican from Wichita.

O’Donnell introduced the produce tax exemption with Sen. Oletha Faust-Goudeau, a Democrat from Wichita, as a beacon of bipartisanship. He said the timing might be right in that the budget crisis will force legislators to delve into the state tax code and crack the door for his bill.

It’s projected to cost the state about $43 million in tax revenue each year, but Faust-Goudeau said in the long term it actually could save the state more in health care costs if it encourages Kansans to eat healthier.

Weight problems are a significant factor in the state’s health care costs.

A report released last year by the Kansas Department of Health and Environment found that as of 2011, 64.4 percent of Kansas adults were overweight, including almost 30 percent classified as obese.

In 2000, only about 21 percent of Kansas adults were obese.

A survey released in 2010 by the federal Centers for Disease Control and Prevention found that less than 25 percent of Kansans reported eating the recommended five combined servings of fruits and vegetables per day.

Healthy encouragement?

Lawrence Gostin, a Georgetown University professor who has studied how changes to the tax code can encourage or deter healthy behaviors, said he had not heard of any other state exempting only fruits and vegetables from its sales tax. But Gostin said he thinks it’s “an excellent idea.”

“Why should states tax healthy behavior, such as eating fruits and vegetables?” he asked. “Government encourages the population to eat healthily, so it shouldn’t tax individuals who comply with these health recommendations.”

Most states exempt all groceries from sales tax. Kansas is one of 14 states that include groceries in their sales tax and, at 6.15 percent, the Kansas tax on food is second highest in the nation, trailing only Mississippi at 7 percent.

Add in sales taxes levied by local governments, and Kansans in many cities and counties pay almost $10 in tax on every $100 grocery bill.

The last time the Kansas Legislature examined the sales tax on food, in 2013, a plan to lower taxes on all groceries to 4.95 percent passed the Senate but faltered in the House.

Sen. Jeff Melcher, a Republican from Leawood, eventually voted for the tax reduction but expressed some concern that it would exacerbate the obesity problem by encouraging people to buy and eat more food.

Gostin said there’s no evidence that’s the case in states with no grocery sales tax.

“But if government subsidizes unhealthy foods such as through corn subsidies, it makes unhealthy foods more affordable and attractive,” he said.

Gostin said that might be one shortcoming of the proposed fruits and vegetables tax exemption: If processed foods remain cheaper even with sales tax included, then the exemption primarily will benefit middle- and upper-class Kansans who already buy more fruits and vegetables.

Increasing the tobacco tax is more likely to benefit overall public health, he said.

Gostin called tobacco taxes “the single most important strategy for reducing smoking, especially among young people.”

He said there is “something psychological” about a tax increase that makes it even more effective in deterring behavior than a tax exemption is at encouraging that behavior.

Bipartisan opposition to tobacco tax

Lobbying groups representing the state’s doctors, dentists and hospitals all lined up to support Brownback’s proposed tobacco tax in a hearing last week. So did Roy Jensen, the director of the University of Kansas Cancer Center, and public health groups like the American Lung Association and the Kansas Health Foundation.

Jeffrey Willett, the foundation’s vice president for programs, said the proposed $1.50 per pack cigarette tax increase is projected to reduce youth smoking in Kansas by 20 percent and encourage about 25,000 Kansas adults to quit.

That would make a dent in the state’s estimated $1 billion a year in tobacco-related health care costs, Willett said, and keep Kansas from sliding further in its efforts to curb smoking.

“In 1991, Kansas had the eighth-lowest adult smoking rate in the nation,” Willett said. “Today, we have dropped all the way to 31st. We believe Kansas can do better.”

Business interests led by the powerful Kansas Chamber of Commerce lined up in opposition to the bill, saying it would only increase cigarette smuggling and black market sales or drive cigarette buyers across the state line to places like Missouri, which has one of the nation’s lowest tobacco taxes.

The Kansas Chamber, in written testimony from CEO Mike O’Neal, declined to address the possible public health benefits.

“Taxing cigarettes and alcohol may be a way to socially engineer behavior, but that is not the expressed intent of this bill,” O’Neal said. “A $107 million price tag has been affixed to this proposal to help plug a hole in the a budget that can be plugged with reductions in spending.”

In the end, there may be bipartisan support for killing the proposed cigarette tax increase.

Republican leaders who, like O’Neal, prefer spending cuts as a budget fix already have voiced opposition. And Democrats who have railed against the income tax cuts that preceded the budget crisis have said they’re loath to use tobacco taxes to fill the hole because they fall disproportionately on poor Kansans — a shortcoming Gostin outlined in a paper published in the journal Promoting Health: Intervention Strategies from Social and Behavioral Research.

Gostin wrote that the cigarette tax, while effective in promoting public health, is “burdensome” on smokers with lower incomes.

“It may compel individuals to pay a ‘health tax’ on a behavior that is addictive and, to a certain extent, beyond the person’s control,” he wrote. “More importantly, the tax is highly regressive because most adults who smoke are in lower socioeconomic classes.”

Editor’s Note: The Kansas Health Foundation is the primary funder of the Kansas Health Institute, which is the parent organization of the editorially independent KHI News Service.

Andy Marso is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

WASHINGTON (AP) — The Supreme Court says Nebraska should pay $3.7 million in damages to Kansas in a long-running legal dispute over use of water from the Republican River.

The justices on Tuesday also agreed with the recommendations of a special master who found that Nebraska should pay $1.8 million on top of actual damages for using more than its legal share of the river’s water in 2005 and 2006.

The dispute centers on a 1943 compact allocating 49 percent of the river’s water to Nebraska, 40 percent to Kansas and 11 percent to Colorado.

Since 1999, Kansas has complained that Nebraska uses more than its fair share of water from the river, which originates in Colorado and runs mostly through Nebraska before ending in Kansas.

PITTSBURG, Kan. (AP) — Pittsburg State University will unveil a donated Andy Warhol artwork this week that will be on display at the university’s new arts center.

A ceremony to unveil the donation from Robert and Gwendolyn Tyler will be held Wednesday morning in the Bicknell Family Center for the Arts.

Rhona McBain, chairwoman of Pittsburg State’s art department, said in a statement Monday that the Warhol piece will be inspiration to those who perform and visit the new arts center.

Robert Tyler, president of Winfield Consumer Products, is a 1975 graduate of Pittsburg State. The Joplin Globe reports the Robert and Gwendolyn Tyler Charitable Foundation has provided funding for the Tyler Research Center and established the Dr. George Graham Plastics Engineering Technology Scholarship.

 

WASHINGTON (AP) —Veterans Affairs Secretary Robert McDonald is apologizing for misstating that he served in the military’s special forces.

McDonald made the erroneous claim while speaking to a homeless veteran during a segment that aired last month on “CBS Evening News.”

McDonald now says “that was inaccurate.”

The secretary apologized in a statement Monday “to anyone that was offended” by his mistaken claim that he was a special forces member. He says he remains committed “to the ongoing effort to reform VA.”

The VA website says McDonald is an Army veteran who completed Ranger training and was awarded the Meritorious Service Medal when he left the military. President Barack Obama chose the former Procter & Gamble CEO to take over the scandal-plagued VA last year, and McDonald took office last July.

By Andy Marso 

For the first time, a Kansas House committee has approved a bill allowing some form of medical marijuana. House Bill 2282 was limited in scope to begin with, and Rep. John Wilson, the bill’s sponsor, proposed amendments to further limit it Monday in the hopes of assuaging concerns about opening the state to legal pot abuse.

The effort worked, and Wilson’s bill passed the House Health and Human Services Committee verbally with only a few “nay” votes. Wilson, a Democrat from Lawrence, said the somewhat anti-climactic vote was appropriate. “We don’t celebrate the passage of other medical or patient-focused bills in here, and I think this is just another one of those bills,” he said. “It just happens to deal with a plant that has a history behind it.”

Since introducing the bill last month, Wilson sought to separate it from much broader medical marijuana bills introduced by fellow Democrats in the House and Senate. He stressed that his bill allows only the use of cannabis too low in THC to provide a “high” and only for the treatment of seizure disorders. “I’m not a foot soldier in any march toward full-scale legalization, recreational marijuana or anything like that,” Wilson said. “

Our bill is structured in such a way that if people want to add any new conditions or any new variety or marijuana or new levels of THC, they’re going to have to come to the Legislature first.” He said the bill as written could appeal to a unique coalition of libertarian-leaning Republicans or those looking to assert states’ rights, as well as progressive Democrats who think marijuana is a safe alternative to traditional drugs.

There is anecdotal evidence that low-grade cannabis oil can reduce the harmful symptoms for children with disorders that cause them to suffer dozens or even hundreds of seizures a day. The most well-known anecdote involves Charlotte Figi, whose treatment success caused supporters to name the treatment “Charlotte’s Web.”

But formal research on the treatment’s risks and rewards has been limited due to the federal government’s classification of marijuana as a Schedule One controlled substance.

Still, in recent years almost half the states have adopted some sort of legal access to cannabis oil. Wilson’s bill, as amended, stipulates that unless the Legislature says otherwise, the oil in question must be made with marijuana that contains no more than 3 percent THC, a level low enough to have basically no intoxicating effect. It also limits its usage strictly to those with a documented seizure disorder.

Wilson’s amendment scuttled a process to petition KDHE for other THC content and for treatment of other disorders, and eliminated an advisory committee that would have been created to evaluate those petitions. The bill as previously written drew opposition from law enforcement and addiction treatment groups who said the petition process created a gaping loophole.

Rep. Dick Jones, a Republican from Topeka, said he still believed the amended bill would put Kansas on a slippery slope toward the situation in Colorado, one of the few states to legalize marijuana for recreational as well as medicinal use.

“I think we’re looking at a Pandora’s box here,” he said. Jones said his personal research had turned up no “definitive statement” from a respected medical institution that medical marijuana is completely safe. Jones was one of the few “no” votes in committee Monday.

Wilson said that does not mean the bill has an easy road. He said he would work to convince the House leadership to allow a floor vote on it, with a soft deadline for passage looming Friday. Even if it does come up for a House vote, there’s no guarantee it would pass there. Rep. Don Hill, a Republican from Emporia, said Monday he was voting for the bill in committee but was undecided on how he would vote if it came to the floor.

Hill said he would prefer to follow the U.S. Food and Drug Administration medication approval process, but he’s sympathetic to parents who don’t think they can wait because of their children’s persistent seizures. “I’m not yet convinced that we have the evidence that we need to have to be certain of the safety as well as the therapeutic benefit — the risk-to-benefit profile,” said Hill, a retired pharmacist. “But I’m also not satisfied that over the last several years we — the federal government, the pharmaceutical industry and our FDA system — have moved as quickly as I would have hoped.”

Andy Marso is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.