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[House Report 106-697]
[From the U.S. Government Publishing Office]

                                                                       
106th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     106-697

======================================================================

 
         RADIATION EXPOSURE COMPENSATION ACT AMENDMENTS OF 1999

                                _______
                                

 June 26, 2000.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. Hyde, from the Committee on the Judiciary, submitted the following

                              R E P O R T

                         [To accompany S. 1515]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on the Judiciary, to whom was referred the 
bill (S. 1515) amending the Radiation Exposure Compensation 
Act, and for other purposes, having considered the same, 
reports favorably thereon with technical amendments and 
recommends that the bill as amended do pass.

                           TABLE OF CONTENTS

                                                                  

                                                                 Page
The Amendment..............................................           2
Purpose and Summary........................................           2
Background and Need for the Legislation....................           2
Hearings...................................................           8
Committee Consideration....................................           8
Committee Oversight Findings...............................           8
Committee on Government Reform Findings....................           8
New Budget Authority and Tax Expenditures..................           8
Congressional Budget Office Cost Estimate..................           8
Constitutional Authority Statement.........................          13
Section-by-Section Analysis and Discussion.................          13
Agency Views...............................................          17
Changes in Existing Law Made by the Bill, as Reported......          19
    The technical amendments (stated in terms of the page and 
line numbers of the reported bill) are as follows:

    Strike ``1999'' each place it appears and insert ``2000''.
    Page 9, line 24, insert ``and'' after `` `corpulmonale' ''.
    Page 10, line 4, strike ``pneumoconiosis'; and'' and insert 
``pneumoconiosis;''.
    Page 10, strike lines 6 and 7.

                          Purpose and Summary

    S. 1515, ``The Radiation Exposure Compensation Act 
Amendments of 1999'' updates the 1990 law that currently 
compensates individuals exposed to radiation from either being 
downwind of a nuclear test blast or involved in the mining of 
uranium ore during the Cold War. Uranium is used by our 
Government in the production of nuclear weapons. This 
legislation increases the number of radiogenic and chronic 
diseases compensable under the Act. The bill also increases the 
number of individuals and States eligible for compensation 
based on scientific and medical information gathered over the 
past decade.

                Background and Need for the Legislation

    During the 1980's, large bodies of evidence were presented 
before Congress, documenting two groups of individuals who had 
been directly harmed by the failure of the Federal Government 
to take necessary precautions during the planning, 
experimentation and execution of the government's program to 
create a nuclear arsenal. The first group were either present 
at the atomic test sites in Nevada during the 1950's and early 
1960's when above-ground nuclear tests were performed, or were 
``downwind'' of the test sites and were bombarded by 
radioactive fallout. These individuals developed a variety of 
diseases caused by radiation, primarily cancers. Prior to 1990, 
Commissions on the Biological Effects of Ionizing Radiation 
(BEIR) had issued three reports, which were used to define 
cancers that arose at higher numbers among members of these 
groups than among individuals exposed to only normal background 
radiation. A standard of proof was established by which 
individuals deemed eligible for compensation had to demonstrate 
that they were in specified locations during the specific time 
periods of nuclear fallout, and that they contracted specified 
diseases. This burden of proof became the basis for the 1990 
legislation, which instructed the Department of Justice (DOJ) 
to administer the Radition Exposure Compensation Program (RECP) 
to aid in the compensation of eligible individuals. In brief, 
individuals who were present in specified counties of Utah, 
Nevada, Colorado, and New Mexico from January 21, 1951, to 
October 31, 1958, or from June 30, 1962, to July 31, 1962, and 
could provide medical documentation to support the basis of 
disease as defined in the Act, are eligible for $50,000 if they 
were downwind from a test site or $75,000 if they were an on-
site participant during the atomic testing.
    In addition, the Radiation Exposure Compensation Act (RECA) 
of 1990 offered compassionate compensation in the amount of 
$100,000 to underground uranium miners who extracted the 
uranium/vanadium radioactive ore, which was the primary fuel 
source for the atomic bombs. The U.S. government purchased ore 
and sponsored mining operations from 1942 through 1971. During 
the early portion of this period, few attempts were made to 
forewarn or protect miners from the known dangers of exposure 
to radiation. For the most part, workers were unskilled 
laborers, often of Native American heritage, who were unaware 
of the potential health hazards of working in and around the 
uranium mines. The radioactive dust and subsequent exposure to 
radioactive particles (radium and radon gas) has been 
recognized as a cause of disease, particularly of lung diseases 
and cancers for decades. Information from studies of mines 
outside the U.S. documented carcinogenic rates of about 1 
percent per year of lung carcinoma among uranium mine workers 
(10,000 times normal) and that approximately 70 percent of all 
deaths of mine workers were due to primary cancer of the 
respiratory system \1\. In August 1949, the Public Health 
Service (PHS) was commissioned to study the effects of exposure 
to radiation on mine workers. It concluded that there was not 
enough information known on the potential health hazards from 
radiation in the uranium mining and milling industry \2\. In 
1950, a PHS study of uranium mines began epidemiological 
studies and general physical examinations (including chest x-
rays and blood and urine analyses) of on-site participants to 
determine the relationship between exposures to radioactivity 
and the biological effects on the miners. During the course of 
a decade, consensual studies were performed on miners who were 
told that the examinations were part of a study of the health 
of uranium miners. It was not until 1964/1965 that the results 
of these studies and the Federal guidelines were established 
for the conduct of federally-funded research projects involving 
radioactive substances. On July 27, 1967, the President 
approved the Federal Regulatory Commission's proposal (Tr. 
1555-1559; Def.Ex. 414; 507) for a uniform Federal radiation 
standard for underground uranium mines. By 1970, the 
regulations concerning the safety procedures that were to be 
maintained in mining were in place. In 1979, in Begay et al., 
and Anderson, et al., suits were filed against the United 
States of America on behalf of Navajo uranium miners asserting 
various negligence claims arising from decisions of the Federal 
Government in the 1940's through the 1960's with respect to 
safety in uranium mines sponsored by the U.S. In a 1984 
decision, the U.S. District Court in Arizona dismissed the 
suits ruling that there was no subject-matter jurisdiction to 
proceed since the alleged acts and omissions of government 
officials were shielded from tort liability by the 
discretionary function exception to the Federal Tort Claims Act 
\3\. In Begay v. United States the court highlighted several 
pieces of information that had not been analyzed in public 
prior to the court hearing and ``concluded that the plight of 
the uranium miners calls for redress.'' \4\ The evidence was 
used as the basis for hearings held by the Congress in 1987-
1989 that laid the groundwork for RECA. The Radiation Exposure 
Compensation Act of 1990 was signed into law on October 15, 
1990 as Public Law 101-426.
---------------------------------------------------------------------------
    \1\ Faden, R.R. (Chair) Advisory Committee on Human Radiation 
Experiments. October 1995, p. 565.
    \2\ Ibid. p.569.
    \3\ John N. Begay v. United States, 591 F. Supp. 991 (1984).
    \4\ Op.Cit. Advisory Committee on Human Radiation Experiments. 
October 1995, p. 577.
---------------------------------------------------------------------------
    After the passage of RECA in 1990 and the implementation of 
the Department of Justice's regulations in 1992, complaints 
began to be registered with congressional offices. The major 
complaints fell into three categories which became the basis 
for the amendments contained in S. 1515. The first complaint 
was over the limited number of diseases for the basis for 
compensation under the Act and those diseases being so narrowly 
defined that many people are excluded. The second complaint was 
over narrow or hypertechnical constructions of the DOJ 
regulations that imposed limitations on individuals never 
intended by Congress. Third, complaints were registered from 
numerous individuals and groups concerning the exclusion of 
other workers involved in the mining of uranium. Over the past 
decade there were also complaints about DOJ delay in the 
processing of claims (Delays were also often caused by the work 
of lawyers representing applicants who file incomplete or 
inaccurate claims). Congressional review of the situation has 
found that, by and large, the Program has been administered as 
well as could be expected given budget constraints. 
Frustrations, disappointments and perceived injustices have 
resulted from either lack of statutory coverage or from a 
perceived lack of compassion in the administration of the 
Program. S. 1515 attempts to broaden the covered individuals 
and diseases while giving the DOJ greater latitude to implement 
the Program.
    Presently, RECA 1990 sets forth a list of 13 ``compensable 
diseases'' that form the basis for compensation for downwinders 
who resided in specific geographical areas within specific 
times during nuclear tests. RECA's list of compensable diseases 
was originally designed to mirror the diseases covered under 
the Radiation Exposed Veterans Compensation Act of 1988 
(REVCA), which provides for compassionate compensation for 
service-based radiation exposure. The 13 diseases covered under 
RECA and REVCA were based on the findings of the 1980 report of 
the Commission on the Biological Effects of Ionizing Radiation 
(BIER).\5\ Late in 1990, after the passage of RECA into law, 
the BIER V report was released providing a great deal of 
additional information on which cancers could truly be deemed 
as radiogenic. Commissioned by the Office of Science and 
Technology Policy's Committee on Interagency Radiation Research 
and Policy Coordination (CIRRPC) of the National Research 
Council, the expert panel provided a detailed summary of the 
current understanding of radiation-induced genetic effects, 
cellular radiobiology and carcinogenic mechanisms, radiation 
carcinogenesis, the effects of radiation on the fetus, and 
radiation epidemiology and risk modeling. The report became the 
principal framework by which requests were made to change RECA 
1990 eligibility requirements. A representative of the Navajo 
Nation (per 1993 testimony before the Senate Labor and Human 
Resources Committee) and the National Association of Radiation 
Survivors, along with the Department of Justice, offered 
recommendations for changes in the list of compensable diseases 
and changes within the restrictions on the current statutory 
list.
---------------------------------------------------------------------------
    \5\ The National Research Council's Committees on the Biological 
Effects of Ionizing Radiation (BIER) have prepared a series of reports 
to advise the U.S. government on the health consequences of radiation 
exposure. The committee may be convened at the request of the Office of 
Science and Technology Policy to conduct a comprehensive review of the 
biological effects of ionizing radiation focusing on specific elements 
of interest.
---------------------------------------------------------------------------
    In 1995, the President's Advisory Committee on Human 
Radiation Experiments presented its report to President Clinton 
summarizing the experiments involving human subjects and 
ionizing radiation conducted from 1944 through 1974. Chapter 18 
of the report dealt specifically with considerations of the 
uranium miners' and downwinders' exposure. The report offered 
specific recommendations with respect to: lowering the 
stringent requirements for compensation of exposed miners; 
eliminating the distinction between smokers and non-smokers in 
any amendments to RECA 1990; and using length of employment 
instead of exposure levels to verify miner eligibility 
requirements. The suggestions were supported by the President's 
Advisory Committee's finding that no exposure measurements are 
available for 90 percent of the years covered for government-
sponsored mines and that the extrapolation used to calculate 
``reconstructed exposure times'' are quite uncertain. 
Furthermore, the President's Advisory Committee found that 
statutory requirement for 200 Working Level Months (WLM) was 
far in excess of the ``probability of causation'' and, that if 
these criteria were to remain, it should be lowered.
    In 1997, at the request of Senator Orrin Hatch three 
experts provided specific recommendations on changes to RECA 
based on the advances in medical knowledge concerning radiation 
induced-disease. Dr. Arthur C. Upton (Chairman, Dept. of 
Environmental Medicine, New York University Medical Center and 
Chair of the BEIR V Committee), Dr. John M. Samet (Professor 
and Chairman, Department of Epidemiology, Johns Hopkins 
University and Chair of the National Research Council) and Dr. 
Duncan C. Thomas (Professor, Department of Preventive Medicine, 
University of Southern California, Los Angeles and member of 
the BIER V Committee) recommended that the ``list of 
compensable diseases for downwinders be expanded to include 
lung, colon, brain, urinary bladder, salivary gland and 
ovarian...[which] will help bring compensation restrictions 
into line with current scientific understanding.'' \6\ In 
addition, it was recommended that the following restrictions on 
eligibility for downwinders be eliminated based on current 
scientific evidence:
---------------------------------------------------------------------------
    \6\ Duncan C. Thomas, Ph.D., Professor and Director, Biostatistics 
Division, University of Southern California School of Medicine, Los 
Angeles, CA. letter to from Senator Orrin G. Hatch, July 11, 1997.

        1) Lwith regard to leukemia, eliminate requirement that 
        initial exposure occur after the age of 20, and retain 
        2-year minimum latency period between first-exposure 
        and onset of disease, but eliminate the requirement 
        that onset of the disease occur 30 years after first 
---------------------------------------------------------------------------
        exposure;

        2) Lwith regard to primary cancer of the thyroid, 
        eliminate exclusion for initial exposures after age 40;

        3) Lwith regard to breast cancer, eliminate exclusion 
        for initial exposures, and include male and female;

        4) Lwith regard to cancer of the esophagus, remove 
        restrictions for alcohol consumption and smoking;

        5) Lwith regard to cancer of the stomach, eliminate 
        requirement that initial exposure occur before age 30;

        6) Lwith regard to cancer of the pharynx, eliminate 
        smoking restrictions;

        7) Lwith regard to cancer of the pancreas, eliminate 
        smoking and coffee consumption restrictions; and

        8) Lwith regard to cancer of the liver, remove 
        restrictions related to cirrhosis and hepatitis B.

The experts also supported reducing the exposure threshold for 
uranium miners to approximately 40 WLM or using a 1-year 
minimum duration of employment criteria for millers. Drs. Samet 
and Thomas recommended extending the uranium miners' provision 
regarding compensation for non-malignant respiratory diseases 
to all former uranium miners (not just those who worked in 
mines on an Indian reservation.)
    In a letter dated January 24, 2000, Robert Raben, Assistant 
Attorney General, U.S. Department of Justice wrote to the 
Judiciary Committee with the views of that Department on S. 
1515. The Department of Justice had been actively involved in 
drafting many of the amendments to RECA 1990 and supports many 
of the provisions offered in S. 1515. The Department supports:

        1. Lthe extension of compensation for silicosis or 
        pneumoconomiosis to all eligible claimants (previously 
        limited only to miners employed on an Indian 
        reservation);

        2. Lthe inclusion of in situ lung cancers for 
        compensation;

        3. Lthe use of pathology reports of tissue biopsies as 
        supportive medical documentation for establishing a 
        non-malignant respiratory disease or lung cancer;

        4. Lthe use of written affidavits by a personal 
        physician as evidence of a disease state;

        5. Lthe use of affidavits to substantiate employment 
        history for purposes of determining working levels 
        months of exposure; and

        6. Lthe ability to use Native American law, tradition, 
        and custom with respect to the submission and 
        processing of claims filed by Native Americans.

    In the January 24, 2000 letter, three significant concerns 
were raised which have been addressed in S. 1515.
    First, the Department believed that expanding compensation 
to include uranium millers and ore transporters was premature 
and should await the results of a National Institute of 
Occupational Safety and Health (NIOSH) study commissioned by 
Congress in 1993. The letter states that this ``ongoing study 
promises to offer meaningful information concerning the health 
effects of radiation on uranium millers.'' \7\ This committee 
believes that S. 1515 should not be delayed to await a study 
that may never be completed. This study, commissioned in 1993, 
was to be completed within 2 years. Whatever the cause for its 
delay, the report is not finished, no preliminary data are 
available, and an exact date of completion has yet to be 
established. Furthermore, given the extremely small groups of 
millers being studied, it is projected that the data will have 
limited statistical significance and will therefore be merely 
anecdotal in nature. It is deemed unnecessary and cruel to tell 
victims awaiting compensation, some near death, to wait for a 
study that may never come or may be inadequate. S. 1515, well-
grounded in scientific principles, represents an intent to 
apologize and offer compassionate compensation to an expanded 
list of individuals who were not included in the 1990 Act but 
who, nonetheless, deserve restitution.
---------------------------------------------------------------------------
    \7\ Robert Raben, Assistant Attorney General, U.S. Department of 
Justice, letter to Congressman Henry J. Hyde, January 24, 2000.
---------------------------------------------------------------------------
    The Department objected to the expansion of downwinder's 
areas to regions not defined by the National Cancer Institute 
(NCI). However, the NCI has no studies ongoing specifically 
monitoring the downwinders' cancer epidemiology. To ignore the 
written and personal testimonies of the hundreds of victims 
themselves or survivors concerning their illnesses is 
unwarranted. The strong evidence they have supplied is 
sufficient to provide relief.
    The Department of Justice objected to lowering the 
radiation exposure threshold requirements for uranium miners to 
40 Working Level Months and the imposition of a 1-year duration 
of employment requirement for millers and transport workers. 
The Department argues that ``no single exposure figure is 
appropriate to establish a point at which it is more likely 
than not that all uranium miners' exposure was the cause of 
subsequent lung disease.'' The Department statement argues 
that, even the current level of exposure, imposed in RECA 1990, 
of 200 WLMs is insufficient to warrant compensation. Based upon 
the thousands of individuals who have been denied compensation 
because of inaccurately counted WLMs and the testimony of 
experts in radiation oncology mentioned earlier in this report, 
the committee determined that a level of 40 WLMs was an 
appropriate resolution between abolishing the exposure limits 
and the current standard. The Department's letter states that 
``ignoring the relative risk variables and compensation 
criteria that the RECA Committee's scientists determined were 
`significant' fails to demonstrate a sound, scientifically-
based approach.'' DOJ has suggested the implementation of a 
multi-scale criteria using either the exposure-based or 
duration of employment models. These models involve computing 
the WLMs, age, time since exposure, smoking habits, and other 
factors for each individual prior to evaluating the disease 
status of the claimant. The major objection to such an approach 
is that for the vast majority of claimants, data will be 
incomplete (e.g. a worker might have a WLM value but no 
documentation of smoking habits). Many workers in the 1940's, 
50's, and early 60's worked in loosely regulated mines or for 
mines whose records are no longer accessible or interpretable. 
To impose additional levels of proof onto an already burdensome 
claims process under such circumstances does not further the 
intent of Congress to provide expanded relief.
    In conclusion, S. 1515 addresses the problems that have 
been identified in the last 10 years with the Act's 
applicability to uranium miners and other individuals.
    The committee wishes to recognizes the tireless efforts of 
the late Mr. Paul Hicks on behalf of those who served in the 
uranium mines and mills throughout the nation. Mr. Hicks fought 
passionately to improve upon the Radiation Exposure 
Compensation Act. The result of his efforts, and those of the 
Navajo Nation and countless others, is the Radiation Exposure 
Compensation Act Amendments of 1999.''

                                Hearings

    The committee's Subcommittee on Immigration and Claims held 
a June 25, 1998, hearing on H.R. 3539, a similar measure 
introduced in the 105th Congress. Testimony was received from 
Honorable Bill Redmond; Donald M. Remy, Deputy Assistant 
Attorney General, Civil Division, Department of Justice; 
Lawrence J. Fine, M.D., Dr. P.H., Director, Division of 
Surveillance, Hazard Evaluations and Field Studies, National 
Institute for Occupational Safety and Health, Center for 
Disease Control and Prevention, Department of Health and Human 
Services; Dr. David Coultos, Health Science Center, University 
of New Mexico; Dr. Susan E. Dawson, Department of Sociology, 
Utah State University, accompanied by Dr. Gary E. Madsen, Utah 
State University; Mr. Paul Robinson, S.W. Research & 
Information Center; Honorable Thomas Atcitty, President, The 
Navajo Nation, accompanied by George Arthur, Counsel Delegate, 
Navajo National Counsel, and E. Cooper Brown, Esquire; 
Honorable Roland Johnson, Governor, Pueblo of Laguna, 
accompanied by Tribal Councilman Larry Lente; Honorable 
Reginald Pascual, Governor, Pueblo of Acoma, accompanied by 
Tribal Councilman David Villo; Mr. Paul Hicks, New Mexico 
Uranium Workers Council, accompanied by Kevin Martinez, 
Esquire; Earl Chavez, Chairman, Cibola County Commission; and 
Curtis Freeman, Utah Uranium Workers Council with additional 
material submitted by the Honorable Jeff Bingaman; the 
Honorable Chris Cannon; and Brandon Reed.

                        Committee Consideration

    On May 24, 2000, the committee met in open session and 
ordered favorably reported the bill S. 1515 without amendment 
by voice vote, a quorum being present.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII of the Rules 
of the House of Representatives, the committee reports that the 
findings and recommendations of the committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

                Committee on Government Reform Findings

    No findings or recommendations of the Committee on 
Government Reform were received as referred to in clause 
3(c)(4) of rule XIII of the Rules of the House of 
Representatives.

               New Budget Authority and Tax Expenditures

    Clause 3(c)(2) of House Rule XIII is inapplicable because 
this legislation does not provide new budgetary authority or 
increased tax expenditures.

               Congressional Budget Office Cost Estimate

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, the committee sets forth, with 
respect to the bill, S. 1515, the following estimate and 
comparison prepared by the Director of the Congressional Budget 
Office under section 402 of the Congressional Budget Act of 
1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, May 31, 2000.
Hon. Henry J. Hyde, Chairman,
Committee on the Judiciary,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 1515, the Radiation 
Exposure Compensation Act Amendments of 1999.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contacts are Cynthia 
Dudzinski (for costs to the Department of Health and Human 
Services), who can be reached at 226-9010; Mark Grabowicz (for 
all other federal costs), who can be reached at 226-2860; Lisa 
Cash Driskill (for the state and local impact), who can be 
reached at 225-3220; and John Harris (for the private-sector 
impact), who can be reached at 226-2618.
            Sincerely,
                                  Dan L. Crippen, Director.

Enclosure
cc:
        Honorable John Conyers Jr.
        Ranking Democratic Member
S. 1515--Radiation Exposure Compensation Act Amendments of 1999.

                                SUMMARY

    S. 1515 would broaden the population covered by the 
Radiation Exposure Compensation Act, which authorizes monetary 
compensation to individuals who were present, or nearby when 
nuclear weapons tests were conducted, or who worked in uranium 
mines, and later developed certain diseases. The legislation 
also would authorize the appropriation of such sums as may be 
necessary for each of the fiscal years 2000 through 2009 for 
the Department of Health and Human Services (HHS) to make 
grants to states to combat radiogenic cancers and diseases.
    CBO estimates that implementing S. 1515 would result in 
additional discretionary spending of about $750 million over 
the 2000-2005 period, assuming appropriation of the necessary 
amounts. About $650 million of this total would be for 
compensation payments to individuals for radiation exposure, 
and the remainder would be spent on HHS grant programs. Because 
S. 1515 would not affect direct spending or receipts, pay-as-
you-go procedures would not apply.
    Current law restricts compensation for radiation exposure 
only to individuals who were present in certain western states 
between 1947 and 1971, and who meet certain requirements 
relating to radiation exposure and medical conditions. S. 1515 
would increase the number of persons eligible for compensation 
payments, by:

         LAdding more qualifying occupations relating 
        to uranium production,

         LIncreasing the number of states covered and 
        extending the time period considered for radiation 
        exposure,

         LAdding more diseases which may qualify 
        individuals for compensation,

         LDecreasing the level of radiation exposure 
        that is necessary to qualify, and

         LMaking certain medical criteria less 
        stringent for potential claimants.

    S. 1515 contains no intergovernmental mandates as defined 
in the Unfunded Mandates Reform Act (UMRA) and would impose no 
costs on state, local, or tribal governments. This legislation 
would create a new private-sector mandate that would reduce the 
fees paid to claimants' attorneys, but CBO estimates that the 
total costs of the mandate would fall below the threshold 
established in UMRA ($109 million in 2000, adjusted annually 
for inflation).

                ESTIMATED COST TO THE FEDERAL GOVERNMENT

    The estimated budgetary impact of S. 1515 is shown in the 
following table. The costs of this legislation fall within 
budget functions 550 (health) and 050 (national defense).

                                     By Fiscal Year, in Millions of Dollars
----------------------------------------------------------------------------------------------------------------
                                                              2000     2001     2002     2003     2004     2005
----------------------------------------------------------------------------------------------------------------
SPENDING SUBJECT TO APPROPRIATION
Compensation Under Current Law \1\                                3       10       10        5        5        5
  Budget Authority/Estimated
  Authorization Level \2\
  Estimated Outlays                                              12       10       10        5        5        5

Proposed Changes

Additional Radiation Exposure                                     0       20      120      200      200      106
Compensation
  Estimated Authorization Level
  Estimated Outlays                                               0       20      120      200      200      106

HHS Grants                                                       20       21       21       21       22       22
  Estimated Authorization Level
  Estimated Outlays                                               1       19       23       22       21       21

    Total Changes                                                20       41      141      221      222      128
      Estimated Authorization Level
      Estimated Outlays                                           1       39      143      222      221      127

Spending Under S. 1515                                           23       51      151      226      227      133
  Estimated Authorization Level
  Estimated Outlays                                              13       49      153      227      226      132
----------------------------------------------------------------------------------------------------------------
\1\ Over the 1991-1999 period, total appropriations of about $238 million were provided for radiation exposure
  compensation.
\2\ The 2000 level is the amount appropriated for that year. The 2001-2005 levels are CBO estimates of
  compensation payments under current law for those years.

                           BASIS OF ESTIMATE

    For this cost estimate, CBO assumes that funds will be 
appropriated for each fiscal year as they are needed to pay 
valid claims and to provide the HHS grants.
Additional Radiation Exposure Compensation
    CBO expects that spending authorized by S. 1515 would 
follow a pattern similar to the payments authorized by the 
Radiation Exposure Compensation Act, but probably would occur 
somewhat faster because potential claimants are more familiar 
with the program. Most payments probably would occur within two 
to four years after enactment and virtually all payments would 
be made within 10 years of enactment. We estimate that 
compensation payments that would be authorized by this 
legislation total about $650 million over the 2000-2005 period, 
and an additional $200 million over the following five years.
    Uranium Miners. CBO estimates that most of the payments 
under S. 1515 would be made to individuals who have worked in 
underground uranium mines. Based on information from the 
National Institute of Occupational Safety and Health, we 
estimate that there are about 20,000 former uranium miners in 
the United States (some of whom may be deceased, but whose 
families could receive payments). Under the Radiation Exposure 
Compensation Act, about 3,000 of these miners have filed claims 
and about half of them were successful. Because S. 1515 would 
cover more diseases that these miners may have developed and 
mining operations in more states over a longer time period, CBO 
estimates that roughly 1,775 additional miners would file 
claims for the first time from 2000 through 2005 and that 75 
percent of these claims would be approved. In addition, we 
expect that most of the 1,500 miners whose claims were 
previously denied would refile and that about 75 percent of 
these claims would be approved, resulting in a total of about 
2,500 successful claims from 2000 through 2005. CBO expects 
approval rates under S. 1515 to be higher than under current 
law because this legislation eases the requirements for 
approval. Each eligible uranium miner would be authorized to be 
paid $100,000 under S. 1515. Thus, implementing these 
provisions would cost about $250 million over the 2001-2005 
period.
    Other Groups Covered by S. 1515. Five other groups of 
individuals may be eligible for compensation under this act, 
including people who:

         LWorked in uranium mills,

         LWorked in above-ground uranium mines,

         LTransported uranium ore from mines to mills,

         LParticipated in atmospheric nuclear tests 
        conducted by the federal government (``on-site 
        participants''), and

         LWere present in certain areas close to such 
        tests (known as ``down-winders'').

    Based on information about these groups from the Department 
of Justice, CBO estimates that roughly 9,600 persons would file 
claims during the 2000-2005 period, and that about 60 percent 
would gain approval and receive payments of $50,000 (for down-
winders), $75,000 (for on-site participants), or $100,000 (for 
other individuals). CBO estimates that, in total, the other 
groups targeted by this legislation would be authorized to 
receive payments of $400 million over the 2001-2005 period.
HHS Grants
    S. 1515 would authorize the appropriation of funds for 
state programs to screen individuals for cancer, provide 
referrals and follow-up services, develop and disseminate 
public information for the detection, prevention, and treatment 
of radiogenic cancers and diseases, and assist applicants in 
the documentation of compensation claims. Based on information 
from HHS, we estimate this work would cost about $20 million 
annually.

                     PAY-AS-YOU-GO CONSIDERATIONS:

    None.

        ESTIMATED IMPACT ON STATE, LOCAL, AND TRIBAL GOVERNMENTS

    S. 1515 contains no intergovernmental mandates as defined 
in UMRA and could benefit state, local, and tribal governments. 
The act would provide competitive grants to entities, including 
state and local governments, that carry out certain programs 
relating to radiation-related diseases.

                 ESTIMATED IMPACT ON THE PRIVATE SECTOR

    S. 1515 would create a new private-sector mandate by 
reducing the limit on attorneys' fees under the Radiation 
Exposure Compensation Act. Current law limits attorneys' fees 
to 10 percent of the payment by the government to the claimant, 
but S. 1515 would set the maximum allowable fee at 2 percent. 
The mandate would primarily affect lawyers representing uranium 
miners and their survivors with claims pending under current 
law. For a successful claim of this type, S. 1515 could cost 
the miner's attorney up to $6,000. CBO anticipates, however, 
that the number of successful claims would be quite low. The 
limit on fees also applies to other types of claims under S. 
1515, but because such claims are difficult to pursue under 
current law costs related to them would not be significant. 
Consequently, the total costs of the mandate would fall below 
the threshold established in UMRA ($109 million in 2000, 
adjusted annually for inflation).

                         PREVIOUS CBO ESTIMATE

    On April 5, 2000, CBO transmitted a cost estimate for S. 
1515, the Radiation Exposure Compensation Act Amendments of 
1999, as passed by the Senate on November 19, 1999. The two 
versions of the legislation are identical, as are the cost 
estimates.

                         ESTIMATE PREPARED BY:

Federal Costs (Health and Human Services): Cynthia Dudzinski 
        (226-9010)
Federal Costs (all other costs): Mark Grabowicz (226-2860)
Impact on State, Local, and Tribal Governments: Lisa Cash 
        Driskill (225-3220)
Impact on the Private Sector: John Harris (226-2618)

                         ESTIMATE APPROVED BY:

Peter H. Fontaine
Deputy Assistant Director for Budget Analysis

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the committee finds the authority for 
this legislation in Article 1, section 8 of the Constitution.

               Section-by-Section Analysis and Discussion

Section 1. Short Title
    Section 1 contains the short title, the ``Radiation 
Exposure Compensation Act Amendments of 1999.''
Section 2. Findings
    Section 2 contains the findings, purpose, and apology. A 
new statement of findings is added. This new statement finds 
that since the enactment of the initial Act regulatory burdens 
have made it too difficult for some deserving individuals to be 
fairly and efficiently compensated. The findings also note the 
need to extend eligibility to States in which the Federal 
Government sponsored uranium mining and milling from 1941 to 
1971, and that scientific data has provided medical validation 
for the extension of compensable radiogenic diseases. The 
findings also add that above-ground uranium miners, millers, 
and transporters of ore should be compensated in a manner 
similar to underground uranium miners when injured by radiation 
exposure. Finally, there is a finding that the Federal 
Government should work with State and local governments and 
healthcare organizations to provide programs for early 
detection, prevention, and education on radiogenic diseases to 
aid the individuals adversely affected by uranium mining and 
nuclear weapons testing.
Section 3. Amendments to the Radiation Exposure Compensation Act
    Section 3 terminates the Trust Fund 22 years after the 
enactment of the RECA Amendments of 1999.
    Section 3 also amends Section 4 of RECA 1990 with regard to 
claims relating to leukemia and other radiogenic diseases as a 
result of atmospheric nuclear testing.
    An individual who was physically present in the affected 
area for at least 1 year during the period from 1/21/51 to 10/
31/58, or who was physically present in the affected area for 
the period beginning on 6/30/62 and ending on 7/31/62 and 
submits written documentation that they developed leukemia 
after the applicable periods of exposure described above more 
than 2 years after the first exposure to fallout are eligible 
for $50,000. An individual who participated in an on-site 
atmospheric nuclear test and submits written documentation that 
they contracted leukemia more than 2 years following the 
nuclear test is eligible for $75,000. Further conditions for 
leukemia claims are that initial exposure to radiation from 
atmospheric testing occurred prior to age 21, that the claim 
for payment is filed with the Attorney General by or on behalf 
of the individual, and that the Attorney General determines in 
accordance with Section 6 of the Act that the claim meets the 
requirements of the Act.
    An individual who was physically present in the affected 
area for at least 2 years between 1/15/51 and 10/31/58 or was 
present in the affected area between 6/30/62 and 7/31/62 and 
submits written documentation of the development of a specified 
radiogenic disease is eligible for $50,000. An individual who 
participated in an onsite atmospheric nuclear test, and submits 
written documentation that he or she developed a specified 
radiogenic disease more than 2 years after the first exposure 
to fallout is eligible for $75,000. These individuals are 
eligible if the claim for such payment is filed with the 
Attorney General by or on behalf of the individual and if the 
Attorney General determines in accordance with Section 6 of 
RECA that the claim meets the requirements of the Act.
    Affected areas for purposes of the Act in which individuals 
were exposed to radiation between 1/15/51-10/31/58 or 6/30/62-
7/31/62 are as follows: Washington, Iron, Kane, Garfield, 
Sevier, Beaver, Milliard, Wayne, San Juan and Piute counties in 
Utah, White Pine, Nye, Lander, Lincoln, Eureka, and Clark 
counties in Nevada, and Coconino, Yavapai, Navajo, Apache, and 
Gila counties in Arizona.
    The specified radiogenic diseases that would qualify 
individuals for compensation are leukemia (other than chronic 
lymphocytic leukemia) provided that initial exposure occurred 
after the age of 20 and the onset of the disease was at least 2 
years after first exposure; lung cancer (other than in situ 
lung cancer that is discovered during or after a post-mortem 
exam); and the following diseases provided onset was at least 5 
years after first exposure: multiple myeloma, lymphomas (other 
than Hodgkin's disease), and primary cancer of the thyroid, 
male or female breast, esophagus, stomach (provided initial 
exposure occurred before age 30), pharynx, small intestine, 
pancreas, bile ducts, gall bladder, salivary gland, urinary 
bladder, brain, colon, ovary, or liver (except if cirrhosis or 
hepatitis B is indicated).
    Section 3 also amends Section 5 of RECA which deals with 
claims relating to uranium mining. An individual is eligible 
for $100,000 if that individual was employed in a uranium mine 
or mill, or transported uranium ore or vanadium-uranium ore 
between 1/1/42 and 12/31/71. If an individual was a miner 
exposed to 40 or more working level months of radiation, he or 
she qualifies for compensation if written medical documentation 
is submitted that the individual developed lung cancer or a 
nonmalignant respiratory disease. If the individual was a 
miller or ore transporter, he or she qualifies for compensation 
if they worked for at least 1 year between 1/1/42 and 12/31/71 
and submits written medical documentation that they developed 
lung cancer or a nonmalignant respiratory disease or renal 
cancers and other chronic renal disease including nephritis and 
kidney tubal tissue injury. Individuals are eligible if they 
worked at a mill in Colorado, New Mexico, Arizona, Wyoming, 
South Dakota, Washington, Utah, Idaho, North Dakota, Oregon, 
Texas, or any other State if an Atomic Energy Commission 
uranium mine was operated in such State between 1/1/42 and
12/31/71, the State submits an application to DOJ to include 
such a State, and the Attorney General determines to include 
said State. These individuals can receive payment if the claim 
is filed with the Attorney General by them or on their behalf, 
and if the Attorney General determines that the claim meets the 
requirements of the Act in accordance with Section 6.
    The term ``medical written documentation'' is defined as 
including ABGs and a chest X-ray read by two certified ``B'' 
readers or an interpreted HRCT scan, or pathology reports of 
tissue biopsies, or pulmonary function tests. Under this 
criteria, written documentation is considered conclusive and 
subject to a fair and random audit procedure established by the 
Attorney General. Written documentation provided by a physician 
must be provided by a physician who is employed by the Indian 
Health Service, the Department of Veterans Affairs, or is a 
board certified physician, and has a documented ongoing 
physician-patient relationship with the claimant.
    The term ``uranium mine'' is defined as any underground 
excavation as well as open pit, strip, rim, surface, or other 
aboveground mines where uranium ore or vanadium-uranium was 
mined and extracted, and the term ``uranium mill'' is defined 
to include milling operations involving the processing of 
uranium ore or vanadium-uranium ore.
    Section 3 changes Section 6 of RECA by first amending the 
establishment of filing procedures to require the Attorney 
General to take into account and make allowances for the law, 
tradition, and customs of Indian tribes and members of Indian 
tribes to the maximum extent possible when establishing these 
procedures. In the determination of claims, all reasonable 
doubt with regard to whether a claim meets the requirements of 
the Act will be resolved in favor of the claimant. Payments to 
individuals or survivors on a claim relating to presence at an 
on-site nuclear test shall be offset by any payment made 
pursuant to a final award or settlement on a claim (other than 
a claim for workers' compensation), or any payment made by the 
Department of Veterans Affairs based on injuries incurred as a 
result of their exposure, based on the actuarial present value 
of such payments. In the case of deceased persons, the 
determination of those individuals eligible to receive 
compensation by virtue of marriage, relationship, or 
survivorship shall take into consideration the laws, 
traditions, and customs of affected Indian tribes.
    With regard to action on claims, the Attorney General shall 
determine each claim no later than 12 months after the claim is 
received. If the claim is denied, the claimant has a reasonable 
period in which to seek administrative review of the denial of 
the claim, after which the Attorney General will make a final 
determination within 90 days of receipt of the claimant's 
request for review. If the Attorney General fails to render a 
determination within 12 months after receipt of such request, 
the claim will be awarded as a matter of law and paid. The 
Attorney General may request any reasonable additional 
information or documentation to determine the claim in 
accordance with the established procedures. The period starting 
when the Attorney General makes a request for additional 
information and ending when the claimant provides that 
additional information or documentation, or notifies the 
Attorney General that they will not or cannot provide the 
information does not fall under the 12-month limitation.
    The Attorney General shall ensure that approved claims are 
paid within 6 weeks of approval. Any procedures on claims shall 
take into consideration and incorporate Native American law, 
tradition, and custom with respect to the claims of Native 
Americans. Not later than 180 days after the date of the 
enactment of the RECA Amendments of 1999, the Attorney General 
shall issue revised regulations to carry out the Act. It should 
be noted that the DOJ has indicated that they feel, due to the 
nature of this expansion of the Act, that 180 days will not be 
sufficient to thoroughly revise the regulations. In addition to 
any other material that substantiates employment history for 
determining working level months, an individual filing a claim 
may make a substantiation by affidavit that meets requirements 
established by the Attorney General which is made by a person 
other than the individual filing a claim attesting to the 
claimant's employment history.
    After the date of enactment of the RECA Amendments of 1999, 
any claimant who has been denied compensation may resubmit a 
claim for consideration by the Attorney General a maximum of 3 
times. Any resubmittal made prior to the date of enactment does 
not apply to the limitation. The time limit to file a claim is 
extended to 22 years following the enactment of the 1999 RECA 
Amendments.
    Attorney fee limitations are reduced from a 10% limit to a 
2% limit of a claimant's payment.
    GAO is directed to submit a report to Congress 18 months 
following the enactment of this Act and every 18 months 
thereafter detailing the administration of RECA by DOJ, 
analyzing claims, awards, and administrative costs and the 
budget of DOJ relating to the Act.
Section 4. Establishment of Program of Grants to States for Education, 
        Prevention, and Early Detection of Radiogenic Cancers and 
        Diseases
    Section 4 establishes a program of grants to States for 
education, prevention, and early detection of radiogenic 
cancers and diseases. Section 4 amends the Public Health 
Service Act (42 U.S.C. Sec. 285) by adding Section 417C. This 
amendment enables the Secretary of Health and Human Services to 
make grants to any National Cancer Institute-designated cancer 
center, Department of Veterans Affairs hospital or medical 
center, Federally Qualified Health Center, community health 
center, or hospital, or an agency of any State or local 
government, including any State department of health, or 
nonprofit organization. The purpose of these will be to carry 
out programs to screen individuals having been exposed to 
radiation for cancer as a preventive health measure, to provide 
referrals for medical treatment of such individuals, to ensure 
that follow-up services are available, to develop and 
disseminate public information programs for the detection, 
prevention and treatment of radiogenic cancers and diseases, 
and to assist applicants in the documentation of claims. This 
includes programs provided through Indian Health Service or 
through tribal contracts, compacts, grants, or agreements with 
the Indian Health Service which are determined appropriate to 
raising the health status of Indians. These grants do not 
affect any coverage obligation of a government or private 
health plan or program relating to an individual .
    Beginning on October 1 following the first appropriation of 
this section and annually on October 1 thereafter, the 
Secretary is to submit a report to the Senate Committees on the 
Judiciary and Health, Education, Labor, and Pensions, and the 
House Judiciary and Commerce Committees summarizing the 
expenditures and programs funded under this section. This Act 
authorizes $20 million in appropriations to carry out this 
section for fiscal year 1999 and such sums as may be necessary 
for fiscal years 2000-2009.

                              Agency Views

                             Department of Justice,
                                  Washington, DC, January 24, 2000.
Hon. Henry J. Hyde, Chairman,
Committee on the Judiciary,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: This provides the views of the 
Department of Justice on S. 1515, the ``Radiation Exposure 
Compensation Act Amendments of 1999,'' as passed by the Senate 
on November 19, 1999, to amend the Radiation Exposure 
Compensation Act (RECA), 42 U.S.C. Sec. 2210 note (1994). 
Although the Department of Justice supports many provisions of 
S. 1515, we do have concerns about several others, as outlined 
in more detail below, and consequently oppose the bill as it is 
currently drafted.
    As an initial matter, the Department supports Section 
3(c)(2)(A)(ii), which would amend RECA to extend compensation 
for silicosis or pneumoconiosis to all eligible claimants. 
Currently, RECA limits compensation for silicosis and 
pneumoconiosis to miners employed in mines on ``an Indian 
reservation.'' 42 U.S.C. Sec. 2210, Section 5(b). Additionally, 
the Department supports Section 3(c)(2)(C), which would allow 
claimants to satisfy the eligibility requirements of RECA 
through the submission of pathology reports of tissue biopsies 
as medical documentation for purposes of establishing a non-
malignant respiratory disease or lung cancer in cases in which 
the claimant is living. Pursuant to our revised regulations, 
the Department has expanded the use of pathology reports of 
tissue biopsies as proof of a non-malignant respiratory 
disease. See 28 C.F.R. Sec. 79.36(d)(ii). The Department also 
supports that part of Section 3(c)(2)(C) of S. 1515 that would 
provide compensation for in situ lung cancers. Recent revisions 
to the Department's implementing regulations include in situ 
cancers in the definition of ``primary lung cancer.'' See 28 
C.F.R. Sec. 79.31(h). Section 3(c)(3) would permit a claimant's 
treating physician to submit a written diagnosis of a non-
malignant respiratory disease or lung cancer accompanied by 
written documentation as conclusive evidence of that disease. 
We would support such a provision, provided that it were 
amended to require that the accompanying written documentation 
included medical records substantiating the treating 
physician's diagnosis.
    The Department also supports the offset provisions 
contained in Section 3(d) of S. 1515 and the provisions 
contained in Section 3(d)(4), which would provide for the 
consideration and incorporation, to the fullest extent 
feasible, of Native American law, tradition, and custom with 
respect to the submission and processing of claims filed by 
Native Americans. Finally, the Department supports Section 
3(e)(2)(A), which would allow, under certain circumstances, 
affidavits to substantiate employment history for purposes of 
determining working level months. As you know, the regulations 
implementing the Act permit claimants to set forth under oath 
on the standard claim form the name of each mine in which the 
claimant worked, as well as the actual time period worked in 
each mine. See 28 C.F.R. Sec. 79.33(b)(2).
    Nevertheless, the Department does have concerns about S. 
1515 and therefore opposes enactment of the bill as it is 
currently drafted. We would be pleased to work with the 
Committee to make appropriate revisions to address our 
concerns. In particular, Section 3(c)(1) of the bill proposes 
to expand compensation under RECA to include uranium millers, 
but does not define what constitutes a ``mill,'' or who will be 
considered a ``miller.'' We believe these fundamental questions 
should be addressed before Congress expands RECA coverage to 
this subset of workers. An ongoing study conducted by experts 
at the U.S. Department of Health and Human Services, National 
Institute of Occupational Safety and Health (NIOSH), upon whom 
the Department of Justice relies for scientific advice and 
expertise, may yield meaningful information concerning the 
health effects of radiation on uranium millers. While the 
Administration recognizes that this study has been ongoing for 
a longer period than initially expected, results are 
anticipated within a year. It is important that any expansion 
of the entitlements in the Act be supported by scientific 
evidence. Accordingly, we believe that changes in this area 
should await the completion of the NIOSH study.
    Similar concerns exist with respect to that part of Section 
3(c)(1) which proposes to compensate transport workers. There 
is little scientific information about this particular category 
of workers. Because uranium ore was transported by truck, rail, 
and even occasionally river barge, the extent of this claimant 
population could be quite extensive. Further, the scarcity of 
existing documentary evidence to establish a work history could 
make administration of this provision problematic. The 
potential cost could be very large. A detailed study of this 
potential group of claimants would likely resolve some of the 
questions concerning eligibility criteria.
    Section 3(b) of S. 1515 would also add several new 
``Downwinder'' and ``Onsite Participant'' diseases. Similarly, 
S. 1515 would increase the Downwinder ``affected area'' to 
include Wayne and San Juan counties in Utah and the counties of 
Coconino, Yavapai, Navajo, Apache, and Gila in Arizona. The 
National Cancer Institute (NCI), the experts in the field, 
advises us that, at this time, NCI cannot offer any scientific 
support for the expansion of the RECA program to include these 
additional diseases, nor are there radiodosimetric studies or 
other scientific findings to support the inclusion of the 
proposed areas.
    We also have concerns about that part of Section 3(c) of S. 
1515 that would reduce the radiation exposure threshold 
requirements for uranium miners to 40 Working Level Months and 
impose a one-year duration of employment requirement for 
millers and transport workers. We object to this provision. The 
Radiation Exposure Compensation Act Committee (``RECA 
Committee''), chartered by the Human Radiation Interagency 
Working Group in 1996, found that no single exposure figure is 
appropriate to establish a point at which it is more likely 
than not that all uranium miners' exposure was the cause of 
subsequent lung disease, and that individual history factors 
must be considered in determining if an illness in a particular 
case is in fact caused by radiation exposure. The RECA 
Committee recommended, alternatively, an exposure-based model 
and a duration of employment model. Both of these are based on 
the relative risk models developed by the National Research 
Council's Committee on the Biological Effects of Ionizing 
Radiation, and applied to updated cohorts of Colorado Plateau 
and New Mexico underground uranium miners.
    In the exposure-based model, compensation is conditioned on 
risk variables that the latest data indicate most significantly 
affect the risk of lung cancer in underground uranium miners: 
cumulative exposure to radon progeny, attained age (the age at 
which the claimants developed cancer), and time since the 
miner's last exposure to radon in the mines. Alternatively, the 
duration of employment model contains criteria that are 
dependent on attained age, time since last exposure and the 
calendar year of first employment. (This last factor is 
significant because the mean level of radon in the mines 
declined appreciably over the years.) In both sets of criteria, 
the miner's smoking status is retained, providing assurances 
that miners are being compensated for the effects of exposure 
to radon, not smoking. Ignoring the relative risk variables and 
compensation criteria that the RECA Committee's scientists 
determined were ``significant,'' fails to demonstrate a sound, 
scientifically-based approach for compensation. Finally, we 
note that expansion of the RECA eligibility criteria, as 
proposed in S. 1515, would require a significant commitment of 
additional resources.
    The Department is proud of the Radiation Exposure 
Compensation Act Program and we look forward to working with 
Congress to improve this unique statute. The Department has 
granted nearly 50 percent of all claims filed, for a total 
amount of $241,192,606.
    We would be pleased to meet with you to discuss these 
issues in more detail, and to discuss how we might work 
together to craft appropriate legislation. Thank you for the 
opportunity to comment on this bill. We hope you find this 
information helpful. Please do not hesitate to contact this 
office if you have additional questions or concerns. The Office 
of Management and Budget has advised that there is no objection 
from the standpoint of the Administration's program to the 
presentation of this letter.
            Sincerely,
                  Robert Raben, Assistant Attorney General.

cc:
        The Honorable John Conyers
        Ranking Minority Member

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):

                  RADIATION EXPOSURE COMPENSATION ACT

           *       *       *       *       *       *       *
SEC. 3. TRUST FUND.

    (a) * * *

           *       *       *       *       *       *       *

    (d) Termination.--The Fund shall terminate 22 years after 
the [date of the enactment of this Act] date of enactment of 
the Radiation Exposure Compensation Act Amendments of 1999. If 
all of the amounts in the Fund have not been expended by the 
end of that 22-year period, investments of amounts in the Fund 
shall be liquidated and receipts thereof deposited in the Fund 
and all funds remaining in the Fund shall be deposited in the 
miscellaneous receipts account in the Treasury.

           *       *       *       *       *       *       *

SEC. 4. CLAIMS RELATING TO ATMOSPHERIC NUCLEAR TESTING.

    (a) Claims.--
            [(1) Claims Relating to Childhood Leukemia.--Any 
        individual who was physically present in the affected 
        area for a period of at least 1 year during the period 
        beginning on January 21, 1951, and ending on October 
        31, 1958, or was physically present in the affected 
        area for the period beginning on June 30, 1962, and 
        ending on July 31, 1962, and who submits written 
        medical documentation that he or she, after such period 
        of physical presence and between 2 and 30 years after 
        first exposure to the fallout, contracted leukemia 
        (other than chronic lymphocytic leukemia), shall 
        receive $50,000 if--
                    [(A) initial exposure occurred prior to age 
                21,
                    [(B) the claim for such payment is filed 
                with the Attorney General by or on behalf of 
                such individual, and
                    [(C) the Attorney General determines, in 
                accordance with section 6, that the claim meets 
                the requirements of this Act.]
            (1) Claims relating to leukemia.--
                    (A) In general.--An individual described in 
                this subparagraph shall receive an amount 
                specified in subparagraph (B) if the conditions 
                described in subparagraph (C) are met. An 
                individual referred to in the preceding 
                sentence is an individual who--
                            (i)(I) was physically present in an 
                        affected area for a period of at least 
                        1 year during the period beginning on 
                        January 21, 1951, and ending on October 
                        31, 1958;
                            (II) was physically present in the 
                        affected area for the period beginning 
                        on June 30, 1962, and ending on July 
                        31, 1962; or
                            (III) participated onsite in a test 
                        involving the atmospheric detonation of 
                        a nuclear device; and
                            (ii) submits written documentation 
                        that such individual developed 
                        leukemia--
                                    (I) after the applicable 
                                period of physical presence 
                                described in subclause (I) or 
                                (II) of clause (i) or onsite 
                                participation described in 
                                clause (i)(III) (as the case 
                                may be); and
                                    (II) more that 2 years 
                                after first exposure to 
                                fallout.
                    (B) Amounts.--If the conditions described 
                in subparagraph (C) are met, an individual--
                            (i) who is described in subclause 
                        (I) or (II) of subparagraph (A)(i) 
                        shall receive $50,000; or
                            (ii) who is described in subclause 
                        (III) of subparagraph (A)(i) shall 
                        receive $75,000.
                    (C) Conditions.--The conditions described 
                in this subparagraph are as follows:
                            (i) Initial exposure occurred prior 
                        to age 21.
                            (ii) The claim for a payment under 
                        subparagraph (B) is filed with the 
                        Attorney General by or on behalf of the 
                        individual.
                            (iii) The Attorney General 
                        determines, in accordance with section 
                        6, that the claim meets the 
                        requirements of this Act.

           *       *       *       *       *       *       *

    (b) Definitions.--For purposes of this section, the term--
            (1) ``affected area'' means--
                    (A) in the State of Utah, the counties of 
                Washington, Iron, Kane, Garfield, Sevier, 
                Beaver, Millard, Wayne, San Juan, and Piute;

           *       *       *       *       *       *       *

                    [(C) that part of Arizona that is north of 
                the Grand Canyon and west of the Colorado 
                River; and]
                    (C) in the State of Arizona, the counties 
                of Coconino, Yavapai, Navajo, Apache, and Gila; 
                and
            (2) ``specified disease'' means leukemia (other 
        than chronic lymphocytic leukemia), provided that 
        initial exposure occurred after the age of 20 and [the 
        onset of the disease was between 2 and 30 years of 
        first exposure,] the onset of the disease was at least 
        2 years after first exposure, lung cancer (other than 
        in situ lung cancer that is discovered during or after 
        a post-mortem exam), and the following diseases, 
        provided onset was at least 5 years after first 
        exposure: multiple myeloma, lymphomas (other than 
        Hodgkin's disease), and primary cancer of the: thyroid 
        [(provided initial exposure occurred by the age of 
        20)], male or female breast [(provided initial exposure 
        occurred prior to age 40)], esophagus [(provided low 
        alcohol consumption and not a heavy smoker)], stomach 
        [(provided initial exposure occurred before age 30)], 
        pharynx [(provided not a heavy smoker)], small 
        intestine, pancreas [(provided not a heavy smoker and 
        low coffee consumption)], bile ducts, gall bladder, 
        salivary gland, urinary bladder, brain, colon, ovary, 
        or liver (except if cirrhosis or hepatitis B is 
        indicated).

SEC. 5. CLAIMS RELATING TO URANIUM MINING.

    [(a) Eligibility of Individuals.--Any individual who was 
employed in a uranium mine located in Colorado, New Mexico, 
Arizona, Wyoming, or Utah at any time during the period 
beginning on January 1, 1947, and ending on December 31, 1971, 
and who, in the course of such employment--
            [(1)(A) if a nonsmoker, was exposed to 200 or more 
        working level months of radiation and submits written 
        medical documentation that he or she, after such 
        exposure, developed lung cancer, or
            [(B) if a smoker, was exposed to 300 or more 
        working level months of radiation and cancer incidence 
        occurred before age 45 or was exposed to 500 or more 
        working level months of radiation, regardless of age of 
        cancer incidence, and submits written medical 
        documentation that he or she, after such exposure, 
        developed lung cancer; or
            [(2)(A) if a nonsmoker, was exposed to 200 or more 
        working level months of radiation and submits written 
        medical documentation that he or she, after such 
        exposure, developed a nonmalignant respiratory disease, 
        or
            [(B) if a smoker, was exposed to 300 or more 
        working level months of radiation and the nonmalignant 
        respiratory disease developed before age 45 or was 
        exposed to 500 or more working level months of 
        radiation, regardless of age of disease incidence, and 
        submits written medical documentation that he or she, 
        after  such exposure, developed a nonmalignant 
        respiratory disease,
shall receive $100,000, if--
            [(i) the claim for such payment is filed with the 
        Attorney General by or on behalf of such individual, 
        and
            [(ii) the Attorney General determines, in 
        accordance with section 6, that the claim meets the 
        requirements of this Act.
Payments under this section may be made only in accordance with 
section 6.]
    (a) Eligibility of Individuals.--
            (1) In general.--An individual shall receive 
        $100,000 for a claim made under this Act if--
                    (A) that individual--
                            (i) was employed in a uranium mine 
                        or uranium mill (including any 
                        individual who was employed in the 
                        transport of uranium ore or vanadium-
                        uranium ore from such mine or mill) 
                        located in Colorado, New Mexico, 
                        Arizona, Wyoming, South Dakota, 
                        Washington, Utah, Idaho, North Dakota, 
                        Oregon, and Texas at any time during 
                        the period beginning on January 1, 
                        1942, and ending on December 31, 1971; 
                        and
                            (ii)(I) was a miner exposed to 40 
                        or more working level months of 
                        radiation and submits written medical 
                        documentation that the individual, 
                        after that exposure, developed lung 
                        cancer or a nonmalignant respiratory 
                        disease; or
                            (II) was a miller or ore 
                        transporter who worked for at least 1 
                        year during the period described under 
                        clause (i) and submits written medical 
                        documentation that the individual, 
                        after that exposure, developed lung 
                        cancer or a nonmalignant respiratory 
                        disease or renal cancers and other 
                        chronic renal disease including 
                        nephritis and kidney tubal tissue 
                        injury;
                    (B) the claim for that payment is filed 
                with the Attorney General by or on behalf of 
                that individual; and
                    (C) the Attorney General determines, in 
                accordance with section 6, that the claim meets 
                the requirements of this Act.
            (2) Inclusion of additional states.--Paragraph 
        (1)(A)(i) shall apply to a State, in addition to the 
        States named under such clause, if--
                    (A) an Atomic Energy Commission uranium 
                mine was operated in such State at any time 
                during the period beginning on January 1, 1942, 
                and ending on December 31, 1971;
                    (B) the State submits an application to the 
                Department of Justice to include such State; 
                and
                    (C) the Attorney General makes a 
                determination to include such State.
            (3) Payment requirement.--Each payment under this 
        section may be made only in accordance with section 6.
    (b) Definitions.--For purposes of this section--
            (1) * * *

           *       *       *       *       *       *       *

            (3) the term ``nonmalignant respiratory disease'' 
        means fibrosis of the lung, pulmonary fibrosis, [and] 
        corpulmonale related to fibrosis of the lung[; and if 
        the claimant, whether Indian or non-Indian, worked in a 
        uranium mine located on or within an Indian 
        Reservation, the term shall also include moderate or 
        severe silicosis or pneumoconiosis; and], silicosis, 
        and pneumoconiosis;
            (4) the term ``Indian tribe'' means any Indian 
        tribe, band, nation, pueblo, or other organized group 
        or community, that is recognized as eligible for 
        special programs and services provided by the United 
        States to Indian tribes because of their status as 
        Indians[.];
            (5) the term ``written medical documentation'' for 
        purposes of proving a nonmalignant respiratory disease 
        or lung cancer means, in any case in which the claimant 
        is living--
                    (A)(i) an arterial blood gas study; or
                    (ii) a written diagnosis by a physician 
                meeting the requirements of subsection (c)(1); 
                and
                    (B)(i) a chest x-ray administered in 
                accordance with standard techniques and the 
                interpretive reports of a maximum of 2 National 
                Institute of Occupational Health and Safety 
                certified ``B'' readers classifying the 
                existence of the nonmalignant respiratory 
                disease of category 1/0 or higher according to 
                a 1989 report of the International Labor Office 
                (known as the ``ILO''), or subsequent 
                revisions;
                    (ii) high resolution computed tomography 
                scans (commonly known as ``HRCT scans'') 
                (including computer assisted tomography scans 
                (commonly known as ``CAT scans''), magnetic 
                resonance imaging scans (commonly known as 
                ``MRI scans''), and positron emission 
                tomography scans (commonly known as ``PET 
                scans'')) and interpretive reports of such 
                scans;
                    (iii) pathology reports of tissue biopsies; 
                or
                    (iv) pulmonary function tests indicating 
                restrictive lung function, as defined by the 
                American Thoracic Society;
            (6) the term ``lung cancer''--
                    (A) means any physiological condition of 
                the lung, trachea, or bronchus that is 
                recognized as lung cancer by the National 
                Cancer Institute; and
                    (B) includes in situ lung cancers;
            (7) the term ``uranium mine'' means any underground 
        excavation, including ``dog holes'', as well as open 
        pit, strip, rim, surface, or other aboveground mines, 
        where uranium ore or vanadium-uranium ore was mined or 
        otherwise extracted; and
            (8) the term ``uranium mill'' includes milling 
        operations involving the processing of uranium ore or 
        vanadium-uranium ore, including both carbonate and acid 
        leach plants.
    (c) Written Documentation.--
            (1) Diagnosis alternative to arterial blood gas 
        study.--
                    (A) In general.--For purposes of this Act, 
                the written diagnosis and the accompanying 
                interpretive reports described in subsection 
                (b)(5)(A) shall--
                            (i) be considered to be conclusive; 
                        and
                            (ii) be subject to a fair and 
                        random audit procedure established by 
                        the Attorney General.
                    (B) Certain written diagnoses.--
                            (i) In general.--For purposes of 
                        this Act, a written diagnosis made by a 
                        physician described under clause (ii) 
                        of a nonmalignant pulmonary disease or 
                        lung cancer of a claimant that is 
                        accompanied by written documentation 
                        shall be considered to be conclusive 
                        evidence of that disease.
                            (ii) Description of physicians.--A 
                        physician referred to under clause (i) 
                        is a physician who--
                                    (I) is employed by the 
                                Indian Health Service or the 
                                Department of Veterans Affairs; 
                                or
                                    (II) is a board certified 
                                physician; and
                                    (III) has a documented 
                                ongoing physician patient 
                                relationship with the claimant.
            (2) Chest x-rays.--
                    (A) In general.--For purposes of this Act, 
                a chest x-ray and the accompanying interpretive 
                reports described in subsection (b)(5)(B) 
                shall--
                            (i) be considered to be conclusive; 
                        and
                            (ii) be subject to a fair and 
                        random audit procedure established by 
                        the Attorney General.
                    (B) Certain written diagnoses.--
                            (i) In general.--For purposes of 
                        this Act, a written diagnosis made by a 
                        physician described in clause (ii) of a 
                        nonmalignant pulmonary disease or lung 
                        cancer of a claimant that is 
                        accompanied by written documentation 
                        that meets the definition of that term 
                        under subsection (b)(5) shall be 
                        considered to be conclusive evidence of 
                        that disease.
                            (ii) Description of physicians.--A 
                        physician referred to under clause (i) 
                        is a physician who--
                                    (I) is employed by--
                                            (aa) the Indian 
                                        Health Service; or
                                            (bb) the Department 
                                        of Veterans Affairs; 
                                        and
                                    (II) has a documented 
                                ongoing physician patient 
                                relationship with the claimant.

SEC. 6. DETERMINATION AND PAYMENT OF CLAIMS.

    (a) Establishment of Filing Procedures.--The Attorney 
General shall establish procedures whereby individuals may 
submit claims for payments under this Act. In establishing 
procedures under this subsection, the Attorney General shall 
take into account and make allowances for the law, tradition, 
and customs of Indian tribes (as that term is defined in 
section 5(b)) and members of Indian tribes, to the maximum 
extent practicable.
    (b) Determination of Claims.--
            (1) In general.--The Attorney General shall, in 
        accordance with this subsection, determine whether each 
        claim filed under this Act meets the requirements of 
        this Act. All reasonable doubt with regard to whether a 
        claim meets the requirements of this Act shall be 
        resolved in favor of the claimant.

           *       *       *       *       *       *       *

    (c) Payment of Claims.--
            (1) * * *
            (2) Offset for certain payments.--(A) * * *
            (B) A payment to an individual, or to a survivor of 
        that individual, under this section on a claim under 
        section 4(a)(2)(C) shall be offset by the amount of--
                    (i) any payment made pursuant to a final 
                award or settlement on a claim (other than a 
                claim for workers' compensation), against any 
                person, or
                    (ii) any payment made by the [Federal 
                Government] Department of Veterans Affairs,

           *       *       *       *       *       *       *

            (4) Payments in the case of deceased persons.--
                    (A) * * *

           *       *       *       *       *       *       *

                    (D) Application of native american law.--In 
                determining those individuals eligible to 
                receive compensation by virtue of marriage, 
                relationship, or survivorship, such 
                determination shall take into consideration and 
                give effect to established law, tradition, and 
                custom of the particular affected Indian tribe.
    (d) Action on Claims.--
            (1) In general.--The Attorney General shall 
        complete the determination on each claim filed in 
        accordance with the procedures established under 
        subsection (a) not later than twelve months after the 
        claim is so filed. For purposes of determining when the 
        12-month period ends, a claim under this Act shall be 
        deemed filed as of the date of its receipt by the 
        Attorney General. In the event of the denial of a 
        claim, the claimant shall be permitted a reasonable 
        period in which to seek administrative review of the 
        denial by the Attorney General. The Attorney General 
        shall make a final determination with respect to any 
        administrative review within 90 days after the receipt 
        of the claimant's request for such review. In the event 
        the Attorney General fails to render a determination 
        within 12 months after the date of the receipt of such 
        request, the claim shall be deemed awarded as a matter 
        of law and paid.
            (2) Additional information.--The Attorney General 
        may request from any claimant under this Act, or from 
        any individual or entity on behalf of any such 
        claimant, any reasonable additional information or 
        documentation necessary to complete the determination 
        on the claim in accordance with the procedures 
        established under subsection (a).
            (3) Treatment of period associated with request.--
                    (A) In general.--The period described in 
                subparagraph (B) shall not apply to the 12-
                month limitation under paragraph (1).
                    (B) Period.--The period described in this 
                subparagraph is the period--
                            (i) beginning on the date on which 
                        the Attorney General makes a request 
                        for additional information or 
                        documentation under paragraph (2); and
                            (ii) ending on the date on which 
                        the claimant or individual or entity 
                        acting on behalf of that claimant 
                        submits that information or 
                        documentation or informs the Attorney 
                        General that it is not possible to 
                        provide that information or that the 
                        claimant or individual or entity will 
                        not provide that information.
            (4) Payment within 6 weeks.--The Attorney General 
        shall ensure that an approved claim is paid not later 
        than 6 weeks after the date on which such claim is 
        approved.
            (5) Native american considerations.--Any procedures 
        under this subsection shall take into consideration and 
        incorporate, to the fullest extent feasible, Native 
        American law, tradition, and custom with respect to the 
        submission and processing of claims by Native 
        Americans.

           *       *       *       *       *       *       *

    (i) Use of Existing Resources.--The Attorney General should 
use funds and resources available to the Attorney General to 
carry out his or her functions under this Act. Not later than 
180 days after the date of enactment of the Radiation Exposure 
Compensation Act Amendments of 1999, the Attorney General shall 
issue revised regulations to carry out this Act.

           *       *       *       *       *       *       *

SEC. 8. LIMITATIONS ON CLAIMS.

    (a) In General.--A claim to which this Act applies shall be 
barred unless the claim is filed within [20 years after the 
date of the enactment of this Act] 22 years after the date of 
enactment of the Radiation Exposure Compensation Act Amendments 
of 1999.
    (b) Resubmittal of Claims.--After the date of enactment of 
the Radiation Exposure Compensation Act Amendments of 1999, any 
claimant who has been denied compensation under this Act may 
resubmit a claim for consideration by the Attorney General in 
accordance with this Act not more than 3 times. Any resubmittal 
made before the date of enactment of the Radiation Exposure 
Compensation Act Amendments of 1999 shall not be applied to the 
limitation under the preceding sentence.

SEC. 9. ATTORNEY FEES.

    Notwithstanding any contract, the representative of an 
individual may not receive, for services rendered in connection 
with the claim of an individual under this Act, more than [10 
per centum] 2 percent of a payment made under this Act on such 
claim. Any such representative who violates this section shall 
be fined not more than $5,000.

           *       *       *       *       *       *       *

                              ----------                              

             SECTION 417C OF THE PUBLIC HEALTH SERVICE ACT

SEC. 417C. GRANTS FOR EDUCATION, PREVENTION, AND EARLY DETECTION OF 
                    RADIOGENIC CANCERS AND DISEASES.

    (a) Definition.--In this section the term ``entity'' means 
any--
            (1) National Cancer Institute-designated cancer 
        center;
            (2) Department of Veterans Affairs hospital or 
        medical center;
            (3) Federally Qualified Health Center, community 
        health center, or hospital;
            (4) agency of any State or local government, 
        including any State department of health; or
            (5) nonprofit organization.
    (b) In General.--The Secretary, acting through the 
Administrator of the Health Resources and Services 
Administration in consultation with the Director of the 
National Institutes of Health and the Director of the Indian 
Health Service, may make competitive grants to any entity for 
the purpose of carrying out programs to--
            (1) screen individuals described under section 
        4(a)(1)(A)(i) or 5(a)(1)(A) of the Radiation Exposure 
        Compensation Act (42 U.S.C. 2210 note) for cancer as a 
        preventative health measure;
            (2) provide appropriate referrals for medical 
        treatment of individuals screened under paragraph (1) 
        and to ensure, to the extent practicable, the provision 
        of appropriate follow-up services;
            (3) develop and disseminate public information and 
        education programs for the detection, prevention, and 
        treatment of radiogenic cancers and diseases; and
            (4) facilitate putative applicants in the 
        documentation of claims as described in section 5(a) of 
        the Radiation Exposure Compensation Act (42 U.S.C. 2210 
        note).
    (c) Indian Health Service.--The programs under subsection 
(a) shall include programs provided through the Indian Health 
Service or through tribal contracts, compacts, grants, or 
cooperative agreements with the Indian Health Service and which 
are determined appropriate to raising the health status of 
Indians.
    (d) Grant and Contract Authority.--Entities receiving a 
grant under subsection (b) may expend the grant to carry out 
the purpose described in such subsection.
    (e) Health Coverage Unaffected.--Nothing in this section 
shall be construed to affect any coverage obligation of a 
governmental or private health plan or program relating to an 
individual referred to under subsection (b)(1).
    (f) Report to Congress.--Beginning on October 1 of the year 
following the date on which amounts are first appropriated to 
carry out this section and annually on each October 1 
thereafter, the Secretary shall submit a report to the 
Committee on the Judiciary and the Committee on Health, 
Education, Labor, and Pensions of the Senate and to the 
Committee on the Judiciary and the Committee on Commerce of the 
House of Representatives. Each report shall summarize the 
expenditures and programs funded under this section as the 
Secretary determines to be appropriate.
    (g) Authorization of Appropriations.--There are authorized 
to be appropriated for the purpose of carrying out this section 
$20,000,000 for fiscal year 1999 and such sums as may be 
necessary for each of the fiscal years 2000 through 2009.

                                  
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