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Dear Bozeman Health Community,

We care about each individual, their health, and bringing meaningful services to support them in their health journey. Consistent with our mission to ensure that the vulnerable have access to the care they need, we as a healthcare organization have taken a strong stance: tobacco is a threat to the communities we serve. We see the incredible suffering tobacco-related diseases and death cause to our neighbors, friends, families, and even our own careteam members. Smoking is the #1 cause of preventable death in Montana and Bozeman Health is a tobacco-free health system because we all know the devastating health outcomes from using these products.

As care team members working with families and kids every day, you see firsthand how important insurance coverage is to promoting active, healthy lifestyles and make it easier to take advantage of low-cost, preventative care. A cornerstone of this coverage is Montana's cost-effective Medicaid program. That's why I wanted to be sure you have the information you need to feel confident in your vote on I-185. This initiative will generate revenue from increasing the state tobacco tax in order to prevent nearly 100,000 hardworking Montana families and veterans from losing their current health coverage through Montana's Medicaid expansion program.

I'm sure you have seen a lot of misleading information about I-185. Big Tobacco corporations have dumped more than $9 million dollars (and counting) into TV, radio, and digital ads designed to confuse you. The fact is, I-185 is about keeping hardworking families and kids healthy, so that they can continue to contribute to the communities where they live, work, and play. Tobacco and tobacco-related diseases kill 1,600 Montanans per year and 28% of cancer deaths in Montana are a result of smoking. Each year in Montana, 19,000 kids are destined for premature death due to these lethal products.

The negative impacts on community health aren't the only consequences. Tobacco use also costs Montanans $440 million dollars a year in health care costs. Right now, every Montana household pays nearly $779 extra in taxes annually to help cover the cost of smoking. What is important to remember is that with I-185, if you don't use tobacco, you don't pay. Not only will this initiative fund programs that prevent kids from smoking and help adults quit smoking, but it will also help to curb the cost of tobacco-related diseases by preventing them in the first place. By voting to increase the cigarette tax by $2.00 per pack, you can be part of the solution to help to prevent 4,800 premature deaths, decrease youth smoking rates by over 20%, help to prevent 8,000 Montana kids from becoming adult smokers, and help 9,300 adults quit smoking.

Medicaid expansion is not a new program – it's the current healthcare 1 in 10 hardworking Montanans are relying on that may expire in 2019 if we do nothing. Supporting I-185 supports Montanans and will help keep rural hospitals open so people across the state have access to the care they need.

However, we must acknowledge that we all need to do more to improve awareness and education around the impacts of tobacco use. We as a Bozeman Health family can do better. We all recognize the dangers – people we know smoke and we certainly don't think badly about them – but we do care about their health. And we must be honest – if an increase in the tobacco tax encourages careteam members to rethink their use of tobacco because of the increased price, that's years added to a healthy life and potentially a life saved. If you're looking for opportunities to help quit, please let us know. We're taking a bold stance and we have resource that are available to you through our engaged health plan to help.

So, don't be deceived by Big Tobacco. Medicaid expansion has saved the State of Montana millions of dollars and will continue to pay for itself through state savings and the funds raised by I-185. It has also helped you, your friends, and your neighbors by reducing medical debts, preventing bankruptcies, and improving credit scores among working families. It's time for us all to make our voices heard – not only to save those we love, but also in support of a healthier Montana and a brighter future for our kids.

Please join me in voting YES on I-185 this November.

My very best -

John Hill
President and CEO
Bozeman Health