[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 584 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                 S. 584

 To amend title XIX of the Social Security Act to permit the Secretary 
  of Health and Human Services to waive recoupment under the medicaid 
program of certain tobacco-related funds received by a State if a State 
uses a portion of such funds for tobacco use prevention and health care 
                      and early learning programs.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 10, 1999

 Mr. Kennedy (for himself and Mr. Lautenberg) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend title XIX of the Social Security Act to permit the Secretary 
  of Health and Human Services to waive recoupment under the medicaid 
program of certain tobacco-related funds received by a State if a State 
uses a portion of such funds for tobacco use prevention and health care 
                      and early learning programs.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Children's Smoking Prevention, 
Health, and Learning Trust Fund Act of 1999''.

SEC. 2. AUTHORITY TO WAIVE RECOUPMENT UNDER THE MEDICAID PROGRAM OF 
              TOBACCO-RELATED FUNDS.

    (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 the comprehensive 
settlement of November 1998 between manufacturers of tobacco products 
(as defined in section 5702(d) of the Internal Revenue Code of 1986) 
and States, or as part of any individual State settlement or judgment 
reached in litigation initiated or pursued by a State against one or 
more such manufacturers, if the Secretary finds that the following 
conditions are met:
            ``(i) Subject to subparagraph (C), with respect to any 
        fiscal year, the State demonstrates, through a plan submitted 
        to, and approved by, the Secretary, that 50 percent of amounts 
        so recovered or paid (in this subparagraph referred to as the 
        `Federal share') during the fiscal year shall be expended 
        consistent with the following:
                    ``(I) At least 35 percent of the Federal share 
                shall be expended on one or more of the tobacco use 
                prevention programs described in subparagraph (D).
                    ``(II) Subject to subparagraph (F), the remainder 
                of the Federal share (determined after the application 
                of subclause (I)) shall be expended on one or more of 
                the health care and early learning programs described 
                in subparagraph (E).
            ``(ii) With respect to any fiscal year--
                    ``(I) the level of funds expended by the State 
                (determined without regard to any portion of the 
                Federal share expended by the State) for any program on 
                which a portion of the Federal share is to be expended 
                is not less than the level of funds expended by the 
                State during the most recent State fiscal year ending 
                before the date on which the State first recovered or 
                received any funds pursuant to a settlement or judgment 
                described in this subparagraph; and
                    ``(II) an amount equal to the Federal share is used 
                to supplement and not supplant the level of funds 
                expended by the State for any such program during such 
                State fiscal year.
            ``(iii) The State files with the Secretary an annual report 
        that, with respect to a fiscal year--
                    ``(I) details how the Federal share of the amounts 
                so recovered or paid has been spent consistent with 
                clause (i); and
                    ``(II) identifies, with respect to each program 
                funded in accordance with clause (i) (and, if 
                applicable, subparagraph (F))--
                            ``(aa) the amount of additional 
                        expenditures made for each such program;
                            ``(bb) the number of additional individuals 
                        participating in the program and the nature of 
                        the services provided; and
                            ``(cc) such other information as the 
                        Secretary determines is necessary.
    ``(C) If any State can demonstrate to the Secretary that the 
Federal share of the total amount expended by the State under this 
title to treat tobacco-induced illnesses is less than 50 percent of the 
total amount recovered or paid to the State as a result of a settlement 
or judgment described in subparagraph (B), clause (i) of that 
subparagraph shall be applied by substituting for `50 percent' the 
percentage so demonstrated by the State.
    ``(D) For purposes of subparagraph (B)(i)(I), tobacco use 
prevention programs described in this subparagraph are the following:
            ``(i) Counter-advertising programs to discourage tobacco 
        use.
            ``(ii) Smoking cessation programs.
            ``(iii) School-based tobacco use prevention programs.
            ``(iv) Community-based tobacco use prevention programs.
            ``(v) Programs to enforce prohibitions on the sale of 
        tobacco products to youth.
            ``(vi) Other State-initiated programs to deter tobacco use 
        and assist individuals suffering from nicotine addiction or 
        smoking-induced disease.
    ``(E) For purposes of subparagraph (B)(i)(II), health care and 
early learning programs described in this subparagraph are the 
following:
            ``(i) Community health centers that receive funds under 
        section 330 of the Public Health Service Act (42 U.S.C. 254b).
            ``(ii) Prescription drug assistance programs to help senior 
        citizens pay for pharmaceuticals.
            ``(iii) The State Children's Health Insurance Program 
        established under title XXI.
            ``(iv) Maternal and child health services provided under 
        title V.
            ``(v) The Child Care and Development Block Grant Act of 
        1990 (42 U.S.C. (42 U.S.C. 9858 et seq.).
            ``(vi) The Safe and Drug-Free Schools and Communities 
        Program under title IV of the Elementary and Secondary 
        Education Act of 1965 (20 U.S.C. 7101 et seq.).
            ``(vii) State-initiated programs approved by the Secretary 
        to--
                    ``(I) make health insurance available to the 
                uninsured;
                    ``(II) provide health services to the underserved 
                or uninsured;
                    ``(III) reduce public health risks; or
                    ``(IV) support medical research and expand access 
                to clinical trials for individuals with serious 
                illnesses.
            ``(viii) State-initiated programs approved by the Secretary 
        to--
                    ``(I) award grants to communities for the creation, 
                improvement, and expansion of early childhood education 
                opportunities; or
                    ``(II) serve the educational and developmental 
                needs of children 5 years of age or younger.
    ``(F) In the case of any State that is a tobacco-growing State, the 
State may use up to 25 percent of the remainder of the Federal share 
(determined after the application of subparagraph (B)(i)(I)) for 
programs to assist tobacco farmers and tobacco workers who have 
sustained an adverse financial impact as a direct result of a 
settlement or judgment described in subparagraph (B).
    ``(G) Amounts provided to a State under any provision of law 
referred to in subparagraph (D) or (E) shall not be reduced solely as a 
result of the availability of funds recovered or received pursuant to a 
settlement or judgment described in subparagraph (B).
    ``(H) If the Secretary determines that amounts described in 
subparagraph (B)(i) are not being spent in accordance with 
subparagraphs (D), (E), and, as applicable, (C) and (F), or that a 
State has failed to comply with the requirements of clauses (ii) and 
(iii) of subparagraph (B), subparagraph (A) and paragraph (2)(B) shall 
apply to such amounts and the Secretary shall take appropriate action 
to offset such amounts from the amounts otherwise paid to the State 
under this title.''.
    (b) Prohibition on Payment for Administrative Expenses Incurred in 
Pursuing Tobacco Litigation.--Section 1903(i) of the Social Security 
Act (42 U.S.C. 1396b(i)) is amended--
            (1) in paragraph (18), by striking the period and inserting 
        ``; or''; and
            (2) by inserting after paragraph (18) the following:
            ``(19) with respect to any amount expended on 
        administrative costs to initiate or pursue litigation against 
        one or more manufacturers of tobacco products (as defined in 
        section 5702(d) of the Internal Revenue Code of 1986).''.
    (c) Effective Date.--The amendments made by this section apply to 
amounts recovered or paid to a State before, on, or after the date of 
enactment of this Act.
                                 <all>