In 1983, two coal miners from southwest Virginia told an Appalshop filmmaker they were worried about a list of social service budget cuts by then-President Ronald Reagan. The reason? They had developed a black lung – a severe and progressive lung disease that results from inhaling dust while working in the coal mines.

In the film, the two miners sit on a sofa in a dimly lit room, frowning. The young man with curly hair makes an angry gesture towards the camera. “Every coal miner who has black lung benefits deserves it,” he says. “And not only that, it’s Reagan’s responsibility. He’s the head of the federal government, he’s their boss.

His companion, an older man with serious eyes, coughed before telling what the doctors told him. “I have no lungs, I have some tissue left,” he says.

It has been nearly forty years, but many former miners with the disease are still struggling to maintain funding for the benefits that keep them alive.

The Black Lung Disability Trust Fund was established to provide lifelong medical care to coal miners suffering from black lung disease. The funding comes from a tax on coal production that will be cut in half if Congress does not act by the end of the year. However, some experts and government officials claim that more changes are needed to help sick miners and respond to a unprecedented push in severe black lung disease.

Rising Costs Due to Coal Bankruptcies and Increased Cases

The trust fund is supposed to be a support. Coal companies are responsible for the cost of their employees’ black lung benefits, and the trust fund exists for cases where the responsible company has gone bankrupt or has been dissolved.

The coal companies claim that they can no longer pay the costs. In 2020, three coal bankruptcies transferred $ 865 million of black lung benefit responsibilities to the trust fund, pushing it even go into deeper debt. The fund’s debt is expected to continue to grow even after years of action in Congress the intention to stabilize the fund. In addition to increasing the excise tax rate, in 2008 Congress forgave $ 6.4 billion, about half of the debt at the time, meaning that instead of being paid by the coal companies, this amount was paid by all taxpayers.

At a recent hearing on the future of the program, Representative Madison Cawthorne, R-NC, argued for less federal involvement, saying Americans proud of their years of hard work did not need the help of the government.

“Like many Americans,” Cawthorne said, “I grew up idolizing Ronald Reagan … government is not the solution, government is the problem.”

Thomas Costa, director of education, workforce and income security for the Government Accountability Office, argued that funding problems will only get worse if companies are not held accountable.

“In addition to the decrease in the amount of charcoal, we have also started to see an increase in the number of coal miners who contract black lung,” Costa said. “So there is a good chance that we will see an increase in liability. ”

Federal researchers said the recently identified group of severe black lung disease affecting miners in the central Appalachian Mountains is the most severe cases of black lungs ever documented, and one of the worst industrial epidemics in American history.

Retired miners who spoke anonymously with ReSource say they are concerned about structural problems created by coal bankruptcies. Even benevolent lawmakers might prefer to keep the excise tax low for fear of further bankrupting the industry on which the tax depends.

Dr Robert Cohen, director of the Mining Education and Research Center at the University of Illinois at Chicago, explained that if companies don’t pay for the benefits, the cost falls on state agencies like Medicaid and the minors themselves. themselves.

“So basically,” Cohen said, “what we’re doing is offloading a health responsibility from the industry that created it onto the general public, it really should be the responsibility of the industry.”

Dr Cohen, a leading black lung researcher, says the epidemic shows no signs of slowing down.

“What we’ve seen with this resurgent epidemic,” Cohen said, “is that it tends to affect young minors… and the disease is serious.”

He further explained that younger and sicker patients mean the Black Lung Disability Trust Fund will have to do its job for a long time, possibly decades.

Past the deadline, an uncertain future

Gary Hairston, president of the National Black Lung Association and former West Virginia coal miner, spent the last chapter of his life fighting to retain the benefits of the black lung. He saw the December 30 deadline approaching more and more with some trepidation. “If we don’t get this big problem through,” he said, “we’ll be in no man’s land. ”

A lower tax rate, he fears, would send the trust fund into further debt as coal failures deplete its resources. Hairston believes that the primary responsibility for paying miners’ benefits rests with the coal companies. But he’s not surprised that discussions have resulted in who else can cover the costs.

“The business always finds a way not to pay,” Hairston said.

A process full of obstacles

There is a special court system for black lung benefit claims. It is a long and complicated process to go through – it is not uncommon for sick minors to give up or die before they have completed the process.

A number of law firms specialize in helping minors navigate the black lung. One of those firms is the nonprofit Appalachian Citizens’ Law Center in Whitesburg Kentucky. Courtney Rhoades, an organizer at CCLA, saw no sign of the work becoming less important.

“Since the pandemic we have seen more people come to the office for benefits,” she said. If the coal closed now, we would see cases for twenty years. ”

The lack of lung health insurance system itself has long been documented as complex and difficult to navigate, with medical diagnosis hard to get under laws which favor doctors paid by the coal companies. Advantages are limit between $ 693 for a primary beneficiary and $ 1,387 for a beneficiary with three or more dependents. The most valuable benefit – medical coverage for black lung treatments – is one that some minors say they were not told about, even after they were successful. A complaint about this practice was filed by West Virginia miner Christopher Godfrey with his attorney Sam Petsonk.

While Hairston, Rhoades, and their allies believe in the need to advocate for tighter government oversight of the program and more generous benefits to deal with inflation, they feel like they’ve found themselves stuck in the position to fight every few years for the renewal of the tax rate. , as the coal companies continue to go bankrupt and the black lung epidemic rages on.

Proposals on the table

The Black Lung Disability Trust Fund derives its money from an excise tax on coal production, and the rate has changed over the years. In 2018, the tax level was cut in half. It was put together again, in 2019, but only for two years. in 2022, it is expected to revert to what it was before, from $ 1.10 per tonne to 55 cents.

West Virginia Democratic Senator Joe Manchin presented a Invoice in September which would extend the higher rate for another ten years. However, Manchin was also instrumental by ending the Build Back Better Act, which provides for a four-year extension of the higher tax rate and which proponents say would go a long way in protecting medically and financially vulnerable people in the coalfields.

On December 20, the United Mine Workers of America issued a declaration urging Senator Manchin to reconsider his position. “We urge Senator Manchin to reconsider his opposition to this legislation and to work with his colleagues to adopt something that will help keep coal miners working and will have a significant impact on our members, their families and their communities, ”said the Minister. communicated.

In the house, Representative Matt Cartwright (D-PA) presented the Black Lung Benefit Improvement Act, which would facilitate access to legal representation, hoping to address long-standing complaints about the slow and difficult process minors face when applying for black lung benefits. A similar bill – the “Act of 2021 on assistance to the survivors of minors” – was presented to the Senate by Manchin with Senators Mark R. Warner (D-VA), Bob Casey (D-PA), Tim Kaine (D-VA) and Sherrod Brown (D-OH).

Defenders are also pushing for stricter labor protections, in particular a new rule on silica dust. Silica dust is highly toxic and is a common byproduct of mining today’s thinner coal seams. The level of exposure to silica dust permitted in coal mines is currently higher than what is permitted in any other workplace. Experts suggest that this could be the main cause of the extreme increase in black lung disease in young minors.

Coal miners in southwest Virginia have been watching us since 1983, sitting on the sofa in a dimly lit room. The black lung is deadly – a slow but sure decline, and it’s likely these two are no longer living.

“Balance the budget by reducing domestic spending,” says the young miner, reflecting on the political issues that will determine the course of his life. “Now, at first glance, that sounds good. But you can’t put a price on your lungs.