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WKU Public Radio is part of a new regional journalism collaborative known as the Ohio Valley ReSource. It's made up of public media stations across Kentucky, Ohio and West Virginia. The collaborative will focus on the changing economy in the region and its effect on jobs, healthcare and infrastructure. Each station taking part in the Ohio Valley ReSource is hiring a reporter to contribute to the effort. WKU Public Radio's reporter is Alana Watson, who will be based in the Bowling Green newsroom. The Ohio Valley ReSource is made possible by member stations and through a grant from the Corporation For Public Broadcasting.

Paying for Black Lung: Renewal Deadline Looms for Overextended Federal Trust Fund

Sydney Boles

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

In the film, the two miners are sitting on a couch in a dimly lit room, their brows furrowed.  The younger man with curly hair gestures angrily at 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 coughs before recounting what doctors have told him. “I’ve got no lungs, I’ve got a few tissues left,” he says.

It’s been almost forty years, but many former miners with the disease are still fighting to maintain funding for the benefits that keep them alive.

The Black Lung Disability Trust Fund was set up to ensure lifelong medical care for coal miners suffering from black lung disease.  Funding comes from a tax on coal production that will be cut in half if congress doesn’t take action by the end of the year. However, some experts and government officials say that more changes are needed to help sick miners, and address an unprecedented surge in severe black lung disease.

Rising Costs from Coal Bankruptcies and Surging Cases

The trust fund is meant to be a back-up. Coal companies are responsible for the cost of their employee’s black lung benefits, and the trust fund exists for cases where the company responsible has gone bankrupt or dissolved.

Coal companies argue they can no longer afford the fee. In 2020, three coal bankruptcies moved $865 million of black lung benefit responsibilities to the trust fund, pushing it even deeper into debt. The fund’s debt is expected to continue growing, even after years of congressional action intending to stabilize the fund. In addition to raising the excise tax rate, in 2008 congress forgave $6.4 billion —  about half of the debt at the time — meaning instead of being paid for by coal companies, that amount was paid for by taxpayers at large.

Credit Committee livestream
Retired miner Gary Hairston shared with Congress the challenges of living with black lung.

At a recent hearing about the program’s future, Representative Madison Cawthorne, R-NC, advocated for less Federal involvement, saying Americans who were proud of their years of hard work didn’t need government handouts.

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

Thomas Costa — the Government Accountability Office’s director of Education, Workforce, and Income Security — argued that the funding issues will only get more severe if companies aren’t held accountable.

“In addition to the decrease in the amount of coal, we’ve also started to see a rise in the number of coal miners who are contracting black lung,” Costa said.  “So there’s a good likelihood that we’ll see an increase in liability.”

Federal researchers have said that the recently identified cluster of severe black lung diseaseaffecting miners in central Appalachia is the largest number of severe black lung cases ever documented, and one of the worst industrial epidemics in American history.

Retired miners who spoke anonymously with the ReSource say they worry about the structural issues created by coal bankruptcies. Even sympathetic legislators might prefer to keep the excise tax low, for fear of further bankrupting the industry that the tax depends on.

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

“So essentially,” Cohen said, “what we’re doing is offloading a health liability 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 younger miners… and that the disease is severe.”

 He explained further that younger, sicker patients mean the black lung disability trust fund will need to do its job for a long time, maybe decades.

Past the Deadline, An Uncertain Future

Gary Hairston, the president of the National Black Lung Association and a former West Virginia coal miner, has spent the latest chapter of his life fighting to retain black lung benefits.  He has watched the December 30 deadline grow closer and closer with some trepidation. “If we don’t get this big deal passed,” he said, “we’ll be in no man’s land.”

 A lower tax rate, he fears, would send the trust fund spiraling even further into debt as coal bankruptcies strain its resources. Hairston believes it’s coal companies’ responsibility, first and foremost, to pay for miner’s benefits. But he’s not surprised that discussions have landed on who else can cover the cost.

“The company always finds a way to get out of paying,” Hairston said.

A Process Full of Obstacles

There’s a special court system set-up for black lung benefits claims. It’s a long and complicated process to navigate —  it’s not uncommon for sick miners to give-up or die before seeing the process through.

A number of law firms specialize in helping miners to navigate the black lung. One such firm is the non-profit Appalachian Citizens’ Law Center, in Whitesburg Kentucky. Courtney Rhoades, an organizer at ACLC, has seen no signs the work is becoming any less important.

“Since the pandemic, we’ve seen more individuals coming into the office for benefits,” she said. “If coal shut down now, we’d see cases for twenty years down the road.”

The black lung benefits system itself has long been documented as complex and difficult to navigate, with medical diagnosis difficult to obtain under laws that favor doctors paid for by coal companies. Benefits are limited to between $693 for one 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 miners report not receiving notice of, even after winning their claim. A complaint about this practice has been filed by West Virginia miner Christopher Godfrey together with his attorney Sam Petsonk.

While Hairston, Rhoades, and their allies believe in advocating for heavier government oversight of the program and more generous benefits to keep up with inflation, they feel like they’re left stuck in the position of fighting every few years for renewal of the tax rate, as coal companies continue to go bankrupt and the black lung epidemic rages on.


Proposals on the Table

The Black Lung Disability Trust Fund gets its money from an excise tax on coal production, and the rate has changed over the years.  In 2018, the tax level was reduced by half. It was bumped back up again, in 2019, but only for two years. in 2022, it’s set to return to where it was before —  to go from $1.10 per ton back to 55 cents.

West Virginia Democratic Senator Joe Manchin introduced a bill in September that would extend the higher rate for ten more years. However, Manchin has also been instrumental in halting the Build Back Better Act, which includes a four-year extension for the higher tax rate, and which advocates say would go a long way towards protecting medically and financially vulnerable people in the coalfields.

On December 20, the United Mine Workers of America released a statement urging Senator Manchin to reconsider his position. “We urge Senator Manchin to revisit his opposition to this legislation and work with his colleagues to pass something that will help keep coal miners working, and have a meaningful impact on our members, their families, and their communities,” the statement reads.

In the house, Representative Matt Cartwright (D-PA) introduced the Black Lung Benefit Improvement Act, which would ease access to legal representation, in hopes of addressing long-standing complaints about the slow and challenging process that miners face when applying for black lung benefits. A similar bill — the “Relief for Survivors of Miners Act of 2021”— was introduced in the Senate by Manchin together with  Senators Mark R. Warner (D-VA), Bob Casey (D-PA), Tim Kaine (D-VA) and Sherrod Brown (D-OH).

Advocates are also pushing for stricter labor protections, particularly a new silica dust rule. Silica dust is highly toxic, and a common byproduct of mining today’s thinner coal seams. The level of silica dust exposure allowed in coal mines is currently higher than what’s allowed in any other workplace. Experts suggest this may be a main cause for the extreme spike of severe black lung disease among younger miners.

The southwestern Virginia coal miners look out at us from 1983, sitting on the couch in a dimly lit room.  Black lung is fatal — a slow, but certain decline, and it’s likely these two are no longer living.

“Balance the budget by cutting domestic spending,” the younger miner says, mulling over the policy questions that will determine the course of his life. “Now on the surface, that sounds good. But you can’t put a price on your lungs.”

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