Andy Beshear’s latest effort to woo Eastern Kentucky voters? Black lung benefits.

Attorney General Andy Beshear stood in the hallway of Primary Care Centers of Eastern Kentucky Thursday listening to company CEO Barry Martin as he was shown where patients are seen for diabetes, gynecology and behavioral health.

But what drew Beshear and Rep. Angie Hatton, D-Whitesburg, to the clinic was a service it can’t offer patients — the ability for radiologists to diagnose black lung cases for workers’ compensation claims.

A bill signed into law by Gov. Matt Bevin changed which doctors in Kentucky are eligible to diagnose coal workers’ pneumoconiosis, or black lung disease. Instead of allowing pulmonologists and radiologists who are federally certified B readers to diagnose the disease, the law said radiologists were no longer qualified.

There are seven doctors in Kentucky eligible to diagnose black lung under the new law, according to the Department of Workers’ Claims in the state Labor Cabinet, but only two of them work with the department and neither of them are based in Eastern Kentucky.

“We need to make sure the people of Eastern Kentucky can get services in their own communities,” said Beshear, a Democrat. “And the fact that someone suffering from black lung right now would have to go to Lexington or Louisville to be diagnosed for a condition they already have is wrong.”

Eastern Kentucky is an important region for Beshear as he campaigns to unseat Bevin, a Republican. Though Bevin won Perry County, where the clinic is located, in 2015 and President Donald Trump won the county in 2016, Bevin’s popularity has plummeted since he proposed changes to Kentucky’s pension systems and had harsh words for his detractors along the way.

Beshear now hopes to capitalize on Bevin’s unpopularity and win back the conservative-leaning registered Democrats in the region who have become reliable voters for Republicans in recent years.

“I believe Matt Bevin is the biggest threat to rural jobs,” Beshear said. “Because he’s the first governor we’ve seen to directly attack public education, then directly attack health care, especially everything positive we’ve been able to do with expanded Medicaid.”

He’s made a point of highlighting issues important to Eastern Kentucky in attempts to undercut the region’s Republican bent. He’s talked about the need to provide reliable access to clean drinking water, which has been a problem in many Eastern Kentucky counties. He’s used his position as attorney general to support miners who lost money as a result of the recent bankruptcy of Blackjewel, LLC.

And he’s talking about black lung.

The change in who can diagnose black lung, which was tucked into a larger bill to overhaul Kentucky’s workers’ compensation system, was opposed by Republicans and Democrats in Eastern Kentucky, in part because it was perceived as a way to limit the number of newly diagnosed black lung cases. Opponents argue that radiologists are even more qualified than pulmonologists to diagnose black lung because it’s their job to look at x-rays.

Rep. Adam Koenig, R-Erlanger, pushed back at a bill sponsored by Hatton to repeal the changes, saying it was “a solution in search of a problem.”

He said his bill was designed to address a Kentucky Supreme Court case that said the standard for miners to be diagnosed with black lung was higher than the rest of the population. He said miners are reimbursed for travel to Lexington and can get free hotel rooms if they have to stay overnight.

“There just seems to be a complete lack of fact driven policy coming out of the Democratic Party,” Koenig said.

There have been 167 new black lung claims since the law went into effect July 2018, a decrease from 2017, according to the Department of Workers’ Claims.

Overall, the disease has surged in recent years throughout Central Appalachia.

Studies published by the National Institute for Occupational Safety and Health show that black lung was all but eradicated in the 1990s, with just 31 cases of progressive massive fibrosis reported nationwide between 1990 and 1999. A 2016 NIOSH study, however, showed that a single radiologist identified 60 current and former miners, most of them from Eastern Kentucky, between January and August 2015 who had the most severe form of black lung.

Whether Beshear’s attempts to court Eastern Kentucky are enough to help him win in November remains unknown. Hatton acknowledged that Trump is popular in the region.

“Andy Beshear’s liberal values are far removed from those of Eastern Kentuckians,” said Davis Paine, Bevin’s campaign manager. “He has unapologetically supported Hillary Clinton and the Democrats’ war on coal. He wants sanctuary cities in Kentucky and has vowed to stop what he called the “negative policies of Donald Trump.”

The governor has made a point to stress his relationship with the White House on the campaign trail, while painting Beshear as someone who would stand in Trump’s way. Wednesday night, Bevin posted a picture of him and Trump on his Facebook page, saying he had spent the evening with Trump in West Virginia.

But Hatton said she thinks voters will be able to distinguish between Bevin and Trump in November, adding that she thinks Bevin has been neglectful of issues in Eastern Kentucky.

“I just think it’s time we had a governor that knows what Eastern Kentucky needs,” Hatton said.

This story was originally published July 25, 2019 at 5:04 PM.