I

106TH CONGRESS

1ST SESSION H. R. 1289

To amend title XIX of the Social Security Act to direct the Secretary

of Health and Human Services to waive recoupment of the Federal

government Medicaid share of tobacco-related State settlements under

certain conditions.

IN THE HOUSE OF REPRESENTATIVES

MARCH 25, 1999

Mr. WAXMAN (for himself, Mr. DINGELL, Mr. RANGEL, and Mr. LEWIS of

Georgia) introduced the following bill; which was referred to the Committee on Commerce

A BILL

To amend title XIX of the Social Security Act to direct

the Secretary of Health and Human Services to waive

recoupment of the Federal government Medicaid share

of tobacco-related State settlements under certain conditions.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Tobacco Use Preven5 tion and Public Health Act of 1999’’.
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1 SEC. 2. WAIVER OF RECOUPMENT OF MEDICAID TOBACCO2 RELATED RECOVERIES.

3 (a) IN GENERAL.—Section 1903(d)(3) of the Social

4 Security Act (42 U.S.C. 1396b(d)(3)) is amended—

5 (1) by inserting ‘‘(A)’’ before ‘‘The’’; and

6 (2) by adding at the end the following:

7 ‘‘(B) Subparagraph (A) and paragraph (2)(B) shall

8 not apply to any amount recovered or paid to a State as

9 part of a settlement or judgment reached in litigation initi10 ated or pursued by a State against one or more manufac11 turers of tobacco products, as defined in section 5702(d)

12 of the Internal Revenue Code of 1986, if (and to the ex13 tent that), with respect to amounts recovered or paid to

14 a State in a fiscal year, the Secretary finds that following

15 conditions are met:

16 ‘‘(i) The State will spend at least 25 percent of

17 the amounts so recovered or paid in any fiscal year

18 on tobacco control activities in accordance with sub19 paragraph (C).

20 ‘‘(ii) The State will spend at least 25 percent

21 of the amounts so recovered or paid in any fiscal

22 year for health activities, including public health ac23 tivities and expenditures described in subparagraph

24 (D), but excluding amounts expended to meet the re25 quirement of clause (i).
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1 ‘‘(iii)(I) Subject to subclause (II), the amounts

2 described in clauses (i) and (ii) will be spent only in

3 a manner that supplements (and does not supplant)

4 funds previously being spent by the State (or local

5 governments in the State) for such or similar activi6 ties.

7 ‘‘(II) At the request of a State, the Secretary

8 may waive the requirement of subclause (I), with re9 spect to not supplanting State and local government

10 expenditures for tobacco control activities, to the ex11 tent that the total level of such expenditures (taking

12 into account expenditures required under clause (i))

13 is sufficient to provide for a well-funded, effective

14 program of tobacco control in the State.

15 ‘‘(C) For purposes of subparagraph (B)(i), expendi16 tures for tobacco control activities are made in accordance

17 with this subparagraph if—

18 ‘‘(i) the expenditures are made for any (or all)

19 of the following activities:

20 ‘‘(I) Activities to reduce the use of tobacco

21 products using methods that have been shown

22 to be effective, such as tobacco use cessation

23 programs, State or local counter-marketing pro24 grams, enforcement of laws relating to tobacco

25 products, community-based programs to dis-
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1 courage the use of tobacco products, and

2 school-based and child-oriented education pro3 grams to discourage the use of tobacco prod4 ucts, and for ongoing evaluations of these pro5 grams.

6 ‘‘(II) Activities to fund research related to

7 nicotine addiction, tobacco use cessation, and

8 prevention of the use of tobacco products, in9 cluding surveillance and epidemiology research

10 related to tobacco.

11 ‘‘(III) Activities to assist in economic de12 velopment efforts designed to aid tobacco farm13 ers and workers and communities as they tran14 sition to a more broadly diversified economy;

15 and

16 ‘‘(ii) the expenditures include an annual con17 tribution by the State of its pro rata share for the

18 National Tobacco Use Prevention Program (under

19 section 3 of the Tobacco Use Prevention and Public

20 Health Act of 1999).

21 ‘‘(D) For purposes of subparagraph (B)(ii), the ex22 penditures described in this subparagraph are State ex23 penditures for outreach activities in enrolling individuals

24 under this title and State expenditures for medical assist25 ance with respect to individuals who are eligible for such
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1 assistance only on the basis of a State plan amendment

2 approved on or after January 1, 1999.

3 ‘‘(E)(i) For purposes of subparagraph (C)(ii), a

4 State’s ‘pro rata share’ for a fiscal year is equal to

5 $605,000,000 (or, if less, the sum of the amounts provided

6 under subsections (a), (b), and (c) of section 3 of the To7 bacco Use Prevention and Public Health Act of 1999 for

8 the fiscal year) multiplied by the ratio of (I) the amount

9 of the State’s aggregate recoveries or payments described

10 in subparagraph (B) for the fiscal year, to (II) the total

11 of such aggregate recoveries or payments for all the States

12 for the fiscal year.

13 ‘‘(ii) Amounts contributed under subparagraph

14 (C)(ii) shall be deposited in a separate account in the

15 Treasury to be known as the ‘National Tobacco Use Pre16 vention Account’. Amounts in such Account shall remain

17 available until expended for obligation under section 3 of

18 the Tobacco Use Prevention and Public Health Act of

19 1999.

20 ‘‘(F) For purposes of applying subparagraph (B) for

21 amounts described in such subparagraph recovered or paid

22 in a fiscal year before fiscal year 2000, such amounts shall

23 be treated as being recovered or paid in fiscal year 2000.’’.

24 (b) EFFECTIVE DATE.—The amendments made by

25 subsection (a) apply to amounts recovered or paid to a
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1 State before, on, or after the date of enactment of this

2 Act.

3 SEC. 3. NATIONAL TOBACCO USE PREVENTION PROGRAM.

4 (a) NATIONAL PUBLIC AWARENESS CAMPAIGN.—

5 There shall be made available from the National Tobacco

6 Use Prevention Account (provided for under section

7 1903(d)(3)(B)(E)(ii) of the Social Security Act) to the

8 Secretary of Health and Human Services, without fiscal

9 year limitation, $500,000,000 for each fiscal year (begin10 ning with fiscal year 2000) to implement a national public

11 awareness campaign to discourage the use of tobacco

12 products.

13 (b) NATIONAL PROGRAM TO REDUCE TOBACCO USE

14 BY MINORITY GROUPS.—There shall be made available

15 from such National Tobacco Use Prevention Account to

16 such Secretary, without fiscal year limitation,

17 $100,000,000 for each fiscal year (beginning with fiscal

18 year 2000) to implement the recommendations contained

19 in the 1998 report by the Surgeon General entitled ‘‘To20 bacco Use Among U.S. Racial/Ethnic Minority Groups’’.

21 The Secretary shall implement such recommendations

22 through the Deputy Assistant Secretary for Minority

23 Health and in consultation with an advisory committee

24 composed of individuals from the private sector who are

25 experienced with respect to minority health concerns.
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1 (c) NATIONAL ECONOMIC STABILIZATION PROGRAM

2 FOR TOBACCO FARMERS.—There shall be made available

3 from such National Tobacco Use Prevention Account to

4 the Secretary of Agriculture, without fiscal year limitation,

5 $5,000,000 for each fiscal year (beginning with fiscal year

6 2000 and ending with fiscal year 2005) to promulgate and

7 enforce regulations to provide economic stabilization for

8 tobacco farmers. Such regulations—

9 (1) shall provide that any manufacturer of to10 bacco products in the United States which purchases

11 (or which controls a person who purchases) tobacco

12 grown in a foreign country in any year, beginning

13 with 2000 and ending with 2004, may not reduce in

14 such year its level of purchases of tobacco from

15 farmers in the United States below the level of such

16 purchases in 1997;

17 (2) may be enforced through an action brought

18 by such Secretary in an appropriate district court of

19 the United States to enjoin any failure to comply

20 with such regulations or to impose a civil penalty for

21 such failure to comply of not more than $25,000 per

22 day of violation; and

23 (3) shall not apply to purchases made on or

24 after January 1, 2005.
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1 (d) ADJUSTMENT.—If the aggregate amount depos2 ited into such National Tobacco Use Prevention Account

3 for a fiscal year is less than the sum of the amounts speci4 fied under subsections (a), (b), and (c) for that fiscal year,

5 the amounts so specified shall be reduced in a pro-rata

6 manner so that the total of such amounts for the fiscal

7 year is equal to the aggregate amount so deposited for

8 the fiscal year.

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