I frequently depend upon the insights of the readers of this diary.

Last Thursday, I wrote that I wasn’t going to repeat the mistake I made 20 years ago of letting money from the settlement with Big Tobacco go to Medicaid, instead of programs that would reduce the number of people who smoke.

My bill this year would create a fund for any monetary damages that the state receives from its lawsuit against the manufacturers and distributors of opioids.

None of the money would go to Medicaid.

Josh Sharfstein, the former Secretary of Health and Mental Hygiene, emailed me:

Medicaid was wrong for tobacco because the money went not just to [smoking] cessation services but to pay bills for all tobacco related consequences.

Bottom line—I would recommend modifying your provision to saying the money can be used for Medicaid, but only for new services, greater reimbursements, or the their care improvements…not to displace existing spending.

I told the chair of the committee that will act on my bill, Delegate Maggie McIntosh, that I would consider Josh’s proposal a friendly amendment.