What’s the difference between a collaborative and a coalition?

About 30 cents a pack.

For more than two years, a disparate mix of business leaders and health care advocates has been pushing to raise the tax on a pack of cigarettes.

This fall, the group splintered amiably, forming two groups — The Cigarette Tax for Health Care Coalition and the S.C. Tobacco Collaborative.

Basically, the coalition wants a 70-cent tax on each pack of cigarettes to pay for health care. The collaborative wants a $1 tax to deter teen smoking.

Wanting to lay out their reasons before the holidays and the Jan. 13 start of the legislative session, both kicked off their campaigns last week, in successive rallies.

Neither’s chance of success is high. Gov. Mark Sanford wants to raise taxes on cigarettes to offset lowering the state income tax; he does not want the added tax revenue to go to health care.

All S.C. Senate and House members also are up for re-election next year, making it unlikely they’ll vote for a tax increase.

“That battle was fought last year and fought hard,” said state Sen. Hugh Leatherman, R-Florence, the Senate Republican leader. “I don’t see a mood in the General Assembly for a tax increase this year.”

FUNDING MEDICAID OR CUTTING SMOKING?

The stage is set for cigarette tax proposals to prompt battles on several fronts next year: Sanford versus business; Sanford versus the General Assembly; Democrats, who generally favor the tax, versus Republicans, who generally oppose it; and even among Republicans, those who like the idea versus those who do not.

But advocates say they must remain optimistic.

The state’s Medicaid budget for the 2004-05 fiscal year already is projected to be short almost $200 million. Collecting more in cigarette taxes would help plug that hole, preserving children’s health insurance and nursing home care.

“I don’t see any alternative,” said Sue Berkowitz, director of the South Carolina Appleseed Legal Justice Center. “The only other option is to cut essential services.”

Berkowitz belongs to The Cigarette Tax for Health Care Coalition, whose members want to raise the tax to at least 70 cents from 7 cents a pack to pay for Medicaid, the health care program for the poor, elderly and disabled.

On Tuesday, coalition members rallied at the Clarion Town House to show off their new logo: a piggy bank smoking a cigarette and frowning, meant to show that smokers incur more health care costs than other people and should pay their fair share.

“Save Medicaid,” said Karl Hoecke, a 9-year-old with Down syndrome who relies on Medicaid to pay for occupational and speech therapy, among other needs.

The coalition includes advocates for the poor and disabled; the AARP; and the S.C. Chamber of Commerce, the state’s largest business lobby, with 2,200 members.

The next day, another group held its kickoff — the S.C. Tobacco Collaborative.

The collaborative split off from the coalition because its members want to focus not on the cost of health care but on the dangers of smoking. Its members include the American Cancer Society, the American Heart Association and the American Lung Association.

“We don’t have any issues on where the money is spent,” said Greg White, vice president of the American Lung Association of South Carolina. “Our main issue is the tax is going to prevent children from becoming addicted” to cigarettes.

The collaborative cites research from the Campaign for Tobacco-Free Kids that shows that increasing the cost of a pack of cigarettes by 10 percent would lead to a 7 percent decrease in youth smoking.

The collaborative wants to raise the tax to $1 a pack.

The cigarette tax has become a popular way for states to raise money in tight budget times; 20 states raised cigarette taxes last year.

‘WHEN THE ELEPHANT FIGHTS’

But the General Assembly has resisted raising South Carolina’s cigarette tax, the fourth-lowest in the nation.

The first year, in 2002, advocates joined, rallied, pleaded — but the plan died amid partisan bickering.

Last session, the group refined its message, held bigger rallies and boasted bigger names — including some of the state’s most influential business leaders.

They organized early and often, touting a poll that showed that 68 percent of South Carolinians supported a higher cigarette tax. They also commissioned an audit showing that not funding Medicaid would mean higher insurance costs for businesses and people with private insurance.

Again, the tax failed, as legislators could not decide how much to raise the tax, and as newly elected Republican Gov. Mark Sanford pushed for a cigarette tax only if it were paired with a commensurate lowering of another tax, such as the state income tax.

Congress also approved a one-time financial bailout to the states, preventing major cuts to Medicaid programs.

But next session the needs will be even greater, exacerbated by the growing costs of health care and the hole existing from last year — Congress’ one-time money won’t be there next year.

Business leaders want a steady source of money for Medicaid.

John Lumpkin, a leading member of the chamber and president of Edens & Avant Real Estate Services, said Medicaid is being held together by “fiscal Band-Aids and financial baling wire.”

The chamber’s presence at last week’s rally bodes ill for Sanford, who has relied on business leaders for political support.

But Sanford spokesman Will Folks said the governor and the chamber share the same goals: tax reform and funding Medicaid.

“We look forward to sitting down with their leadership in the days to come and discussing how we can accomplish both of those objectives,” Folks said.

But Ian Hamilton, public-policy director of The Alliance for South Carolina’s Children, fears the intra-State House fights again may prevent the tax from passing.

“When the elephant fights, the grass loses.”

Reach Bauerlein at (803) 771-8485 or vbauerlein@thestate.com.