An advocacy group says Wisconsin falls short when it comes to protecting residents from the harms of tobacco.

Wisconsin got an A for smoke-free air — protecting people in public and at work, but Dona Wininsky with the American Lung Association-Wisconsin chapter says the Badger State only got a B for its cigarette tax. She says Wisconsin’s tax is higher than the national average. The tax increases the overall price, which is a great deterrent for using the product.

The group’s State of Tobacco Control 2012 report grades the state based on existing policies. As for tobacco control and funding, the state got an F. The report also gives Wisconsin an F for its coverage of cessation treatments and services. Wininsky says the state’s Quitline is underfunded. The CDC’s recommendation is $10.50 per smoker to adequately help them quit; instead, the Quitline is currently funded at 73 cents per smoker. Wininsky says she doesn’t have huge expectations to be funded at the high levels recommended by the CDC, but says she would at least like to see the program restored to where it had been before the cuts in the recent budget.

Wininsky says, at 20.7 percent, the high school smoking rates are still “uncomfortably” high, but she says the good news is the percentage of youth smokers is down from previous years. According to the American Lung Association, 443,000 people die from tobacco-related illnesses and secondhand smoke exposure each year. Tobacco causes an estimated 7,240 Wisconsin deaths annually and costs the state’s economy $3.7 billion in healthcare costs and lost productivity. Compared to the rest of the nation, Wisconsin falls somewhere in the middle.

Wininsky says up until last year, Wisconsin was getting an F in smokefree air, too. So, going from F to A is a leap forward. Also, the cigarette tax has been increased a couple of times, which helps deter people from smoking in the first place.

The American Cancer Society calls Wisconsin giving back millions in federal health care dollars, “a move backward.” The funding was intended to help set up a state health care exchange but Governor Walker is turning down the $38 million in Early Innovator Grant funds and stopping work on the exchange.

Allison Miller with the ACS says these networks would allow affordable insurance to be accessed. She says the uninsured tend to not keep up on preventative testing: the result is higher health costs which put taxpayers on-the-hook.

“Congress found that in 2008, the cost of providing uncompensated care to uninsured individuals was about $43 billion,” said Miller.

Governor Walker said in a statement he is concerned with, “increased health care costs and insurance premiums.”

The exchanges are part of a federal mandate under the Affordable Care Act.

A Republican state lawmaker says he was just as surprised as anyone to learn about a letter from federal officials ordering the state to lift a cap on the Family Care program.

State Representative Dean Kaufert (R-Neenah) was at the press conference Wednesday morning, where Governor Walker announced he was ending the cap because of cost savings found in the program.

Kaufert says no mention was about a letter sent by federal officials earlier this month, which informed the state the cap was not allowed and directed officials to reopen the program. Kaufert says the first he found about it was when the letter became public later that day.

The Neenah Republican, who backed efforts to create the Family Care program, says the letter is clearly what “forced the administration’s hand” on lifting the cap.

AUDIO: Rep. Dean Kaufert (:15)

Despite the omission, Kaufert says lifting the cap is still the right thing to do and more people will now be able to take advantage of the program. However, he says the governor will likely need to do mend some fences to win legislative approval for the expansion plan, which will go before the Joint Finance Committee early next year.

AUDIO: Rep. Kaufert (:09)

The Walker administration insists it was the Governor’s decision to lift the cap, saying he always planned to do so by the end of the year.

Rick Schuh, WHBY

Democrats say a proposal to expand Family Care is just Governor Walker trying to claim credit for something he had no control over.

The governor on Wednesday offered a plan to lift an enrollment cap and to make the program providing long-term care assistance for the elderly and disabled available in every county. State Representative Jon Richards (D-Milwaukee) says federal officials actually deserve credit for the decision, based on a letter sent to the state earlier this month that informed the administration that program enrollment could not be capped under the waiver agreement with the state.

The December 13th letter from the Centers for Medicare and Medicaid Services ordered the state to remove the cap, and to admit anyone who had applied after it was put in place July 1st as part of the state budget. Richards says Walker taking credit for something he is being forced to do by the Obama administration is “despicable.”

Richards and several other Democratic lawmakers sent a letter to federal officials earlier this year, asking them to reject Wisconsin’s request for a cap on the program.

The Walker administration maintains Wednesday’s press conference, which made no mention of the letter, was part of an ongoing commitment to lift the cap on Family Care enrollment. A spokesman for the governor says the cap was always intended to be temporary.

In a statement released Thursday, state Department of Health Services Secretary Dennis Smith adds that the plan to expand the program to all 72 counties goes beyond any ongoing discussions with federal officials.

AUDIO: Andrew Beckett reports (1:08)