I 
119TH CONGRESS 
1ST SESSION H. R. 4705 
To place a moratorium on the issuance and renewal of certain Federal 
authorizations for mountaintop removal coal mining until a health study 
is conducted, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 23, 2025 
Mr. MCGARVEY (for himself, Mr. HUFFMAN, Mr. TONKO, Ms. SALINAS, Ms. 
TLAIB, and Mr. COHEN) introduced the following bill; which was referred 
to the Committee on Natural Resources, and in addition to the Commit-
tees on Energy and Commerce, and Transportation and Infrastructure, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To place a moratorium on the issuance and renewal of cer-
tain Federal authorizations for mountaintop removal coal 
mining until a health study is conducted, and for other 
purposes. 
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 ‘‘Appalachian Commu-
nities Health Equity Act of 2025’’ or the ‘‘ACHE Act of 
2025’’. 
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SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Communities surrounding mountaintop re-
moval coal mining projects, which involve surface 
coal mining including blasting with explosives in the 
steep slope regions of Kentucky, Tennessee, West 
Virginia, and Virginia, have raised concerns that 
pollution of the water, air, and soil that results from 
mountaintop removal coal mining may be causing 
health crises in their communities. 
(2) Peer-reviewed scientific research and re-
ports have raised serious concerns about mountain-
top removal mining with respect to elevated risks in 
categories of birth defects studied, including cir-
culatory, respiratory, central nervous system, mus-
culoskeletal, and gastrointestinal. 
(3) Mountaintop removal coal mining has also 
been associated with elevated levels of adult hos-
pitalizations for chronic pulmonary disorders and hy-
pertension that are elevated as a function of county- 
level coal production, as are rates of mortality, lung 
cancer, and chronic heart, lung, and kidney disease. 
These health problems strike both women and men 
in mountaintop removal coal mining communities 
and these elevated levels of disease, defects, and 
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mortality persist even after controlling for other 
variables. 
(4) Scientific evidence, and the level of public 
concern, warrant immediate action to stop new 
mountaintop removal coal mining permits and in-
crease environmental and human health monitoring 
at existing mountaintop removal coal mining 
projects while the reported links between health ef-
fects and mountaintop removal coal mining are in-
vestigated by Federal health agencies. 
(5) The National Institute of Environmental 
Health Sciences is uniquely qualified to manage a 
working group of Federal health agencies with ex-
pertise that is relevant to study of the reported 
links. 
SEC. 3. HEALTH STUDY. 
(a) STUDY.—The Director of the National Institute 
of Environmental Health Sciences, in consultation with 
the Administrator of the Environmental Protection Agen-
cy and the heads of such other Federal agencies as the 
Director determines appropriate, shall conduct or support 
a comprehensive study regarding the health impacts, if 
any, of mountaintop removal coal mining on individuals 
who reside in communities in close proximity to mountain-
top removal coal mining projects. 
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(b) REPORT.—The Director of the National Institute 
of Environmental Health Sciences shall submit to the Sec-
retary, and make publicly available, a report regarding the 
results of the study conducted or supported under sub-
section (a). 
(c) DETERMINATION.—After receipt of the report re-
quired under subsection (b), the Secretary shall publish 
on the website of the Department of Health and Human 
Services a determination regarding whether mountaintop 
removal coal mining presents any health risks to individ-
uals who reside in communities in close proximity to 
mountaintop removal coal mining projects. 
SEC. 4. MOUNTAINTOP REMOVAL COAL MINING FEDERAL 
AUTHORIZATION MORATORIUM. 
No Federal authorization may be issued or renewed 
for any mountaintop removal coal mining project, or for 
any expansion of such a project, by any of the following 
individuals before the date on which the Secretary pub-
lishes a determination under section 3(c) concluding that 
mountaintop removal coal mining does not present any 
health risks to individuals who reside in communities in 
close proximity to mountaintop removal coal mining 
projects: 
(1) The Secretary of the Army, acting through 
the Chief of Engineers, or a State, under section 
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404 of the Federal Water Pollution Control Act (33 
U.S.C. 1344). 
(2) The Administrator of the Environmental 
Protection Agency, or a State, under section 402 of 
the Federal Water Pollution Control Act (33 U.S.C. 
1342). 
(3) The Secretary of the Interior, acting 
through the Director of the Office of Surface Mining 
Reclamation and Enforcement, or a State, under the 
Surface Mining Control and Reclamation Act of 
1977 (30 U.S.C. 1201 et seq.). 
SEC. 5. MOUNTAINTOP REMOVAL COAL MINING MONI-
TORING. 
(a) MONITORING REQUIREMENT.—Any person that 
conducts a mountaintop removal coal mining project 
shall— 
(1) with respect to the site of the project, carry 
out monitoring for pollution that occurs as a result 
of the project, including— 
(A) continuous monitoring for water, air, 
and noise pollution; and 
(B) consistent monitoring for soil pollu-
tion; and 
(2) based on the results of the monitoring car-
ried out under paragraph (1)— 
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