Former Pike County coal miner Kenny Fleming put his hand to his chest and stopped to catch his breath.
“I get tired just talking,” he said during a recent interview.
Fleming is one of the more than 12,000 former miners who receive benefits from the Black Lung Disability Trust Fund, a program that helps miners afflicted with the deadly and debilitating disease pay for health care and some of their basic living costs.
Amid the largest surge of black lung cases in decades, the fund faces steep cuts that could, experts say, eventually leave miners like Fleming without the benefits they need to survive.
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Starting January 1, the tax coal companies pay to fund the program is scheduled to be slashed by 55 percent. Because the fund already holds about $4.3 billion of debt, the tax cut could eventually lead the program to insolvency.
“It’s the beginning of a scenario where you could see very sick miners having to do without health care, and ultimately it could cost them their lives,” said Wes Addington, deputy director of the Appalachian Citizens’ Law Center.
Addington specializes in black lung and mine safety litigation. For many of the former miners and widows he represents, the benefits they receive from the fund are “the difference between making it and not.”
“Depending on how sick the miner is, it’s life and death,” he said.
The trust fund’s beneficiaries, who include former miners and their dependents, generally receive a monthly cash payment between $650 and $1,300, along with medical benefits to pay for their black lung-related treatments, according to a May 2018 report to Congress from the U.S. Government Accountability Office.
As of fiscal year 2017, the fund gave benefits to about 25,700 miners and their dependents. Founded in 1979, the fund gets its revenue from a per-ton tax that coal companies pay on the coal they mine.
But during the 1980s, the tax failed to cover the trust fund’s expenditures. Borrowed money and interest payments drove the fund deep into debt. By 2008, the trust fund owed more than $10 billion to the U.S. Treasury.
A debt forgiveness program in 2008, and the refinancing of the fund’s legacy debt at a lower interest rate, helped bring the fund out of that hole, but the Great Recession and the general decline of coal production meant the fund continued to borrow money from 2010 to 2017.
Last year, the fund still owed about $4.3 billion.
“If the tax is decreased by more than 50 percent … eventually the trust fund will almost quadruple in debt,” Addington said. “More likely, we could see the fund basically become insolvent.”
For former miners like Fleming, the notion that coal companies and legislators would allow that to happen makes him feel betrayed.
“Through our toil and efforts, and through our deteriorating health, we sustained profits for them,” Fleming said. “I know for a fact the coal companies are in a much better position to pay that small amount per ton than the average man is to try to exist without those funds, or for those to be decreased.”
“It would be a catastrophe. I doubt that very many people would come out of it with any semblance of a normal life,” he said.
In October, U.S. Senate Majority Leader Mitch McConell, who is from Louisville, indicated he would work to keep the tax at its current level. “That’ll be taken care of before we get into an expiration situation,” he said, according to WFPL.
Stephanie Penn, a spokeswoman for McConnell, said in an email to the Herald-Leader this week that the fund will continue to exist and “benefits will remain at current levels even if the tax rate is reduced at the end of the year.”
McConnell’s office did not elaborate on how exactly those benefits would remain secure after the tax cut.
“Senator McConnell will continue to prioritize maintaining the benefits offered through the disability fund to help those miners in Kentucky and throughout the country that rely on them,” Penn said.
Black lung spike
Black lung is incurable and often leads to an early death. It’s caused by breathing in dust created during mining, and leaves people with severe shortness of breath and other ailments.
The disease has contributed to the deaths of more than 76,000 miners since 1968, and the rate of black lung has spiked in recent years, particularly in Central Appalachia.
About 5 percent of miners in the late 1990s had black lung, but that rate jumped to more than 20 percent for underground miners in Central Appalachia last year, according to a National Institute for Occupational Safety and Health study published in July.
A recent investigation by NPR and Frontline found that more than 2,000 coal miners suffered from the advanced state of black lung between 2011 and 2016, far more than the federal estimate of 99 cases.
Other reports have also documented the recent surge.
In 2016, the National Institute of Occupational Safety and Health released a report that showed between January and August 2015, a single radiologist identified 60 current and former miners in Central Appalachia, mostly in Eastern Kentucky, who had the most severe form of the disease. Just 31 cases were reported nationwide between 1990 and 1999.
Experts say the surge of black lung resulted from a number of factors, including long shifts for miners who are exposed to dust, and because the mineable coal seams that remain are much thinner than they used to be, which means miners must cut through more silica-laden rock — studies have shown silica is even more dangerous than coal dust.
The NPR and Frontline investigation showed that federal regulators knew about the dangers of silica dust, but failed to impose adequate regulations. Coal operators, too, allowed miners to work in conditions they knew could lead to higher risk of black lung disease.
‘They’ve got to pay the bills’
Johnny Wright, a former miner from Pike County with black lung, said many miners he worked with knew the dust posed some danger, but worked through it because there weren’t many other options for good employment.
“A lot of times these miners will stay underground knowing that they’ve got (black lung) because they’ve got to pay the bills,” Wright said. “I know me, I had three children and was worried about them. You wanted to see them do better than what you did — you wanted to see them better educated.”
In addition to poor regulations and increased exposure to silica dust, few miners have participated in NIOSH’s black lung screening program, meaning there may be many more current and former miners who have black lung but haven’t been tested.
NIOSH is asking miners, miner advocates and others to participate in an active Request for Information survey, available online, to answer questions about barriers to screening programs.
Addington, the attorney from the Appalachian Citizens’ Law Center, said McConnell should “do what he promised,” and keep the tax at its current level, if not raise it.
“In October, McConnell said we wouldn’t get to an expiration situation. Now it seems like the National Mining Association and their lobbyists have gained some traction within Congress,” Addington said. “We’re heading exactly to an expiration situation.”