129th MAINE LEGISLATURE
		LD 1028		LR 493(06)
	An Act To Prevent and Reduce Tobacco Use with Adequate Funding and by Raising the Tax on Tobacco Products
	Fiscal Note for House Amendment " " to Committee Amendment "A"
	Sponsor: Rep. Tipping of Orono
	Fiscal Note Required: Yes
Fiscal Note
			FY 2019-20	FY 2020-21	Projections  FY 2021-22	Projections  FY 2022-23
Net Cost (Savings)
	General Fund		($934,095)	$5,135,686	$6,209,139	$6,217,079
Appropriations/Allocations
	General Fund		($513,295)	$5,116,645	$5,129,112	$5,118,112
	Federal Expenditures Fund		$7,830,484	$11,701,882	$11,700,415	$11,700,315
Revenue
	General Fund		($526,125)	($965,966)	($1,080,027)	($1,098,967)
	Federal Expenditures Fund		$7,831,484	$11,701,882	$11,700,415	$11,700,415
	Other Special Revenue Funds		($1,375)	($9,524)	($9,475)	($9,524)
Transfers
	General Fund		$946,925	$946,925	$0	$0
	Other Special Revenue Funds		($946,925)	($946,925)	$0	$0
Fiscal Detail and Notes
	Part A of the amendment provides an exemption to the tobacco products tax for electronic smoking devices and liquids used with medical marijuana.  General Fund revenue relative to the committee amendment would be reduced by $526,125 in fiscal year 2019-20 and $965,966 in fiscal year 2020-21.  Local Government Fund revenue would be reduced by $1,375 in fiscal year 2019-20 and $15,826 in fiscal year 2020-21.
	Part A of this amendment also reduces the General Fund appropriations to the Department of Health and Human Services by $3,550,000 in fiscal year 2019-20 and $1,000,000 in fiscal year 2020-21 for evidence-based tobacco use prevention and cessation services and for tobacco use cessation medications and counseling provided to MaineCare members.
	Part B of this amendment includes General Fund appropriations to the Department of Health and Human Services of $1,662,060 in fiscal year 2019-20 and $3,329,640 in fiscal year 2020-21 to increase the reimbursement rate for ambulance services under the MaineCare program so the rates are not less than  the average allowable reimbursement rate under Medicare and reimbursement for neonatal transport services under MaineCare must be at the average rate for critical care transport services under Medicare. Federal Expenditures Fund allocations are also included for the FMAP match.
	Part C of the amendment provides a subtraction modification from income tax for student loan payments made by a taxpayer's employer directly to a lender on behalf of a qualified health care employee.  It would result in a reduction of General Fund revenue of $133,000 in fiscal year 2021-22 and a reduction in Local Government Fund revenue of $7,000 in fiscal year 2021-22.  The Department of Administrative and Financial Services would require a one-time General Fund appropriation of $11,000 in fiscal year 2021-22 for computer programming to update the individual income tax return.
	Part C of this amendment also includes General Fund appropriations to the Department of Health and Human Services of  $1,374,645 in fiscal year 2019-20 and $2,787,005 in fiscal year 2020-21 for the Department of Health and Human Services to amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 45 regarding the department's total annual obligation to rural and nonrural hospitals and acute care critical access hospitals and to amend its rule Chapter 101: MaineCare Benefits Manual, Chapter II, Section 103 regarding the department's reimbursement methodology to provide an alternative payment methodology option for rural health clinics. Federal Expenditures Fund allocations are also included for the FMAP match.
	Part D of this amendment transfers $946,925 from the Hospital Tax, Other Special Revenue Funds account in the Department of Health and Human Services to the unappropriated surplus of the General Fund in each year of the biennium.