What the Settlement Bought
The 1998 tobacco Master Settlement Agreement committed states to roughly $206 billion over twenty-five years, yet contained no requirement to spend any of it on tobacco. The suits rested on recovering what states spent treating smokers, but the agreement did not. States put small shares into tobacco control and sold their payment streams to bond investors. The opioid settlements were drafted with earmarks, and accounting shows how far spending still strays.
Who's who
- Mike LewisMississippi attorney who proposed suing for the state rather than the smoker
- Mike MooreMississippi attorney general who filed the first state suit in 1994
- Hubert H. Humphrey IIIMinnesota attorney general who took his case to trial in 1998
- Cezary PodkulProPublica reporter who documented states selling settlement streams to bond investors
- Aneri PattaniKFF Health News reporter who built the opioid settlement spending database
- Theodore HolfordLead author of the 2014 JAMA tobacco control lives-saved estimate
- Stephen LoydTennessee physician quoted on what opioid settlement money was meant for
Where it happens
- Mississippi+4 more episodesFirst state to file suit and settle, for $3.4 billion
- MinnesotaTrial forced millions of industry documents into public view
- Florida+3 more episodesSettled separately for $11.3 billion
- Texas+2 more episodesSettled separately for roughly fifteen billion dollars
Timeline
- May 23, 1994Mississippi files suit seeking roughly $940 million in smoking-related Medicaid costs.
- November 23, 1998Forty-six states and others sign the Master Settlement Agreement.
- 2004States put 3.9 percent into tobacco control and 17.9 percent into debt service on securitized funds.
- August 7, 2014ProPublica reports more than 100 securitization deals and $36 billion in outstanding bonds.
- July 21, 2021The national opioid settlement is announced with at least 85 percent required for abatement.
- December 16, 2024KFF Health News finds about a third of early opioid money spent, a third reserved, a third untrackable.
Still debated
Whether the agreement rests on a Medicaid-recovery theory is contested, since the suits did but the recitals do not. The 3.5 percent figure combines settlement revenue with excise taxes, and the truth campaign's 450,000 averted starts is a modeled estimate. Settlement figures are orders of magnitude, since payments shift each year.