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Here’s a tough question: Would you rather have healthcare for poor people or profits for tobacco companies? This is the question facing Montana voters this November, with an initiative on the ballot to fund the continuation of their Medicaid expansion by taxing tobacco products. This seems like a slam dunk. But, and I know this is shocking, tobacco companies are spending big on lying to voters about the initiative, according to a Tuesday story by the Washington Post.

The Affordable Care Act left Medicaid expansion up to individual states, and the fight to expand Medicaid in many states is still ongoing. Many conservative states have ended up with compromise versions of expansion, with Republicans only agreeing to expand Medicaid if they also enact vicious work requirements. Montana’s compromise was including a sunset provision that would end the expansion if it wasn’t reauthorized by the state legislature in 2019. The tobacco tax plan, known as Initiative 185 or I-185, would circumvent the possibility that the legislature chooses not to renew the expansion.

It’s a good plan for a lot of reasons: Tobacco products do cause health problems, and it’s fair that companies that profit off that suffering should pay up to fund the cost of healthcare. It’s also politically smart, since it’s hard to come up with a less sympathetic industry than the tobacco industry. They profit off getting people addicted to their extremely deadly product, and despite falling rates of smoking among Americans, they profit big time: Altria, formerly known as Philip Morris, paid out dividends of $4.8 billion to its shareholders in 2017.

But as we know, big corporations will fight tooth and nail to prevent any sort of new taxes, regardless of how obscene their profits are, and they will spend as much money as necessary to fight them. According to the Post, Altria is investing millions in the effort:

A political action committee created to launch an opposition campaign against the ballot initiative, called Montanans Against Tax Hikes, is almost entirely funded by tobacco companies like Altria, Inc., which is the parent company for Phillip Morris. In its most recent state campaign finance filing, which covers the period from July 28 to August 27, Altria had given the PAC more than $7 million.

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According to the committee’s latest campaign finance reports, MATH has raised $7.7 million, with only $75 coming from sources other than Altria. In Montana, $7.7 million goes a long way: The smaller the number of people reached by a TV station, the cheaper the ads, and Montana has a total population of only around a million people. Meanwhile, the group promoting the initiative has raised only around $2 million, according to the Post. Last night, Montana Public Radio reported that the Altria-funded PAC violated state campaign finance law when it “failed to report campaign expenditures and used banned automated telephone solicitations.”

The Altria-funded PAC is also essentially lying about what the initiative would do. In its statement to the Post, the group described the initiative as “a massive new tax increase.” But the tax would be levied directly on tobacco products, meaning you’ll only pay those taxes if buy those products. The PAC is implying that this is like any other tax increase, levied across the population, like income tax or the Social Security tax. It’s not! It’s an increase in the price of a product, not a state-levied extraction of money from people’s paychecks; it is easily avoided by not buying cigarettes. Besides, if Altria was truly appalled at its poor customers having to pay more and wanted to atone for its sins of, you know, selling a product that causes cancer, it could swallow that tax increase itself and not pass it on to their customers, or only pass along some of it. But that wouldn’t be profitable, of course.

As the Post reported, if the Medicaid expansion ends, around 100,000 Montanans will lose coverage—roughly 10 percent of the state’s population. Shelling out $7 million on ads that lie about taxes is nothing for Altria, but for those 100,000 Montanans, losing their healthcare is everything; it is literally a matter of life and death. But it’s not like tobacco companies aren’t used to playing with that.