Op/Ed: Don't tax Montanans' medicine cabinets

Politicians in Helena need to understand that good intentions and well wishes don’t count for much when their decisions cause harm to Montanans. 

Montanans are aware of the damage the opioid epidemic has caused to families, friends, and our communities. The state has taken many commendable steps to combat opioid addiction. However, the need to fight opioid abuse does not excuse bad policy making.

Helena politicians are working on proposal to impose a new tax on prescription medication in order to address the opioid epidemic. This tax, if passed, will have far reaching consequences for patients and taxpayers. 

It will increase the costs to patients for necessary medication. It will increase the costs of certain opioid addiction treatments. It will set an unfortunate and unacceptable precedent—that the State of Montana will tax you based on what medications you take. What this tax will not do is further a responsible and coordinated response to the opioid crisis. 

Disruption, increased costs, limited access to care—these are just a few of the negative outcomes a tax on our healthcare supply chain could invite. Lawmakers will claim that this legislation is targeting big PhRMA—drug manufacturers—making them pay to stop the pain and suffering felt by the opioid epidemic. That is false. 

Just as we see with all taxes, the intended targets are never the ones actually footing the bill. It’s normally the consumers. In this case, those consumers are patients struggling with chronic pain that makes everyday tasks difficult unless they have access to pain management.

To absorb the costs of this tax, patients could see insurance premiums increase and the cost of prescription medications skyrocket even higher. In a state with the 49th lowest take-home pay and an unstable health insurance market, Montana’s patients cannot afford additional healthcare costs. They’re already making significant sacrifices to pay for their treatment and care. 

The proper way to hold the health care industry accountable—whether it is drug manufacturers or providers over-prescribing opioids—is to enforce consumer protection laws and ensure best practices are being followed by doctors and hospitals. Punitive taxes on patients’ medication is a misguided tool that will only harm Montanans who are already struggling. 

Equally as concerning, a large portion of our state’s patients rely on Medicaid for health insurance. In fact, Medicaid makes up 17.9 percent of the state budget. This also puts Montana’s taxpayers in the crosshairs of an opioid tax. 

What this tax does not do, however, is penalize illegal drugs and hold criminals accountable. Increasingly, illicit drugs like heroin, fentanyl, and synthetic opioids have become leading killers in our state. These products are unregulated, highly-addictive, and easily accessible through the extensive drug trafficking networks that get these substances across our borders from Canada and Mexico. 

Taxing the healthcare industry, patients, and taxpayers is not going to reduce the number of illicit drugs being pumped onto our streets. We must shift our legislative priorities and focus on solutions that help those Montanans who need pain management while reducing the risks of opioid addiction. Placing a regressive tax on medication falls short of that goal.

Instead of increasing taxes on patients, policymakers could prioritize a response to opioid addiction within the existing House Bill 2 budget.  A coordinated, prioritized response would attempt to reduce barriers to treatment for those who need it while not erecting any new barriers for patients with legitimate pain needs.

We all hope that one day opioid medications will be a treatment of the past, and legitimate patients will be able to seek other avenues of care. Until then, we cannot penalize those who utilize opioids to manage severe, unbearable pain by further burdening them with tax increases on their medicine.

Brent Mead, CEO, Montana Policy Institute