HELENA — Montana voters rejected a ballot measure that sought to extend the state's Medicaid program by raising the tobacco tax.
The ballot measure was the target of multimillion-dollar campaigns that filled the airwaves with ads, including $17 million spent by Altria, the parent company of Philip Morris USA.
Helena voter Alice Elliott said she voted against the tax measure because she thought both sides had tried to mislead the public with their ads.
"In a case like that, you vote no," she said Tuesday. "I just think we were not fully informed."
The results mean the expanded Medicaid program covering 96,000 people will expire next year unless the Montana Legislature renews it. That sets up a potential repeat of the 2015 battle between the Republican-led Legislature and Democratic Gov. Steve Bullock before compromise legislation passed with bipartisan support.
The initiative would have raised the state's tax on a pack of cigarettes to $3.70, raised the tax on snuff and created a new tax on vaping products. Estimates had put the additional revenue at $74 million a year by 2023.
Besides Medicaid expansion, the money would have gone toward other health and veterans programs and into the state's general fund.
Montana's tobacco tax hasn't changed since 2005. The most recent effort to raise it was shot down during the 2017 legislative session, with tobacco industry lobbyists playing a major role in its defeat.
The industry-led campaign to defeat the measure argued that the tax hike would not pay the state's entire share of the Medicaid expansion, creating an unfunded mandate of up to $34 million a year.
Charles Denowh, a lobbyist who led the committee opposing the measure, said state lawmakers now have the chance to decide the future of Medicaid expansion with fair and sustainable funding.
"Special interests tried and failed to bypass the Legislature and permanently lock into place a program designed to be re-evaluated," he said.
Supporters of the measure, primarily health care organizations, say the opponents' calculation does not take into account money saved by keeping people off traditional Medicaid or the premiums paid by the enrollees in the expansion program.
The tobacco tax was one of four ballot measures that went before voters Tuesday.
Montana voters rejected another citizens' initiative that would have increased cleanup standards for companies that plan to open new mines in the state.
Voters also approved two legislative referendums.
One will restrict who can turn in another person's absentee ballot to relatives, caregivers and acquaintances — a measure that Republican lawmakers said will reduce the possibility of ballot tampering. Get-out-the-vote organizations say it will result in fewer elderly, disabled and minority voters participating.
The final measure will extend by 10 years a statewide property tax that provides about $20 million annually to the Montana University System.