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 Com-
mittee 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 condi-
tions.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Tobacco Use Preven-
tion and Public Health Act of 1999’’.
SEC. 2. WAIVER OF RECOUPMENT OF MEDICAID TOBACCO-
RELATED RECOVERIES.
(a) IN GENERAL.—Section 1903(d)(3) of the Social
Security Act (42 U.S.C. 1396b(d)(3)) is amended—
(1) by inserting ‘‘(A)’’ before ‘‘The’’; and
(2) by adding at the end the following:
‘‘(B) Subparagraph (A) and paragraph (2)(B) shall
not apply to any amount recovered or paid to a State as
part of a settlement or judgment reached in litigation initi-
ated or pursued by a State against one or more manufac-
turers of tobacco products, as defined in section 5702(d)
of the Internal Revenue Code of 1986, if (and to the ex-
tent that), with respect to amounts recovered or paid to
a State in a fiscal year, the Secretary finds that following
conditions are met:
‘‘(i) The State will spend at least 25 percent of
the amounts so recovered or paid in any fiscal year
on tobacco control activities in accordance with sub-
paragraph (C).
‘‘(ii) The State will spend at least 25 percent
of the amounts so recovered or paid in any fiscal
year for health activities, including public health ac-
tivities and expenditures described in subparagraph
(D), but excluding amounts expended to meet the re-
quirement of clause (i).
‘‘(iii)(I) Subject to subclause (II), the amounts
described in clauses (i) and (ii) will be spent only in
a manner that supplements (and does not supplant)
funds previously being spent by the State (or local
governments in the State) for such or similar activi-
ties.
‘‘(II) At the request of a State, the Secretary
may waive the requirement of subclause (I), with re-
spect to not supplanting State and local government
expenditures for tobacco control activities, to the ex-
tent that the total level of such expenditures (taking
into account expenditures required under clause (i))
is sufficient to provide for a well-funded, effective
program of tobacco control in the State.
‘‘(C) For purposes of subparagraph (B)(i), expendi-
tures for tobacco control activities are made in accordance
with this subparagraph if—
‘‘(i) the expenditures are made for any (or all)
of the following activities:
‘‘(I) Activities to reduce the use of tobacco
products using methods that have been shown
to be effective, such as tobacco use cessation
programs, State or local counter-marketing pro-
grams, enforcement of laws relating to tobacco
products, community-based programs to dis-
State before, on, or after the date of enactment of this
Act.
SEC. 3. NATIONAL TOBACCO USE PREVENTION PROGRAM.
(a) NATIONAL PUBLIC AWARENESS CAMPAIGN.—
There shall be made available from the National Tobacco
Use Prevention Account (provided for under section
1903(d)(3)(B)(E)(ii) of the Social Security Act) to the
Secretary of Health and Human Services, without fiscal
year limitation, $500,000,000 for each fiscal year (begin-
ning with fiscal year 2000) to implement a national public
awareness campaign to discourage the use of tobacco
products.
(b) NATIONAL PROGRAM TO REDUCE TOBACCO USE
BY MINORITY GROUPS.—There shall be made available
from such National Tobacco Use Prevention Account to
such 
Secretary, 
without 
fiscal 
year 
limitation,
$100,000,000 for each fiscal year (beginning with fiscal
year 2000) to implement the recommendations contained
in the 1998 report by the Surgeon General entitled ‘‘To-
bacco Use Among U.S. Racial/Ethnic Minority Groups’’.
The Secretary shall implement such recommendations
through the Deputy Assistant Secretary for Minority
Health and in consultation with an advisory committee
composed of individuals from the private sector who are
experienced with respect to minority health concerns.
(c) NATIONAL ECONOMIC STABILIZATION PROGRAM
FOR TOBACCO FARMERS.—There shall be made available
from such National Tobacco Use Prevention Account to
the Secretary of Agriculture, without fiscal year limitation,
$5,000,000 for each fiscal year (beginning with fiscal year
2000 and ending with fiscal year 2005) to promulgate and
enforce regulations to provide economic stabilization for
tobacco farmers. Such regulations—
(1) shall provide that any manufacturer of to-
bacco products in the United States which purchases
(or which controls a person who purchases) tobacco
grown in a foreign country in any year, beginning
with 2000 and ending with 2004, may not reduce in
such year its level of purchases of tobacco from
farmers in the United States below the level of such
purchases in 1997;
(2) may be enforced through an action brought
by such Secretary in an appropriate district court of
the United States to enjoin any failure to comply
with such regulations or to impose a civil penalty for
such failure to comply of not more than $25,000 per
day of violation; and
(3) shall not apply to purchases made on or
after January 1, 2005.
(d) ADJUSTMENT.—If the aggregate amount depos-
ited into such National Tobacco Use Prevention Account
for a fiscal year is less than the sum of the amounts speci-
fied under subsections (a), (b), and (c) for that fiscal year,
the amounts so specified shall be reduced in a pro-rata
manner so that the total of such amounts for the fiscal
year is equal to the aggregate amount so deposited for
the fiscal year.
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