CNN recently told the story of miners and miners’ widows in eastern Kentucky. They all share three things in common:
1) They are all affected by black lung, either directly or indirectly.
2) The all voted for Donald Trump.
3) They all now fear what is going to happen if Trump follows through on his promise to repeal the Affordable Care Act (ACA, or Obamacare).
All of the voters CNN speaks to said they were inclined to vote for Trump despite their fears, because he said he was going to bring coal-mining jobs back. And now that he won, and they have had time to process his message, they are afraid.
Whether the good people of rural, southern Appalachia knew it or not, many of them have reaped the benefits the ACA has provided them. This doesn’t just include insurance coverage where perhaps there had been no possibility before. No, those in coal country benefited another way, through easier access to substantial benefits for victims of black lung, a disease caused by the build-up of coal dust over years and years of exposure. Those with black lung suffer greatly from inflammation and fibrosis of the lungs. A diagnosis generally marks the end of a career and the beginning of a steady decline in health.
According to the US Department of Labor, the ACA restores benefits and entitlements to both victims and survivors of black lung:
The first amendment mandates a presumption of total disability or death caused by pneumoconiosis for coal miners who worked for at least 15 years in underground (or comparable surface) mining and who suffer or suffered from a totally disabling respiratory impairment. The second amendment provides automatic entitlement for eligible survivors of miners who were themselves entitled to receive benefits as a result of a lifetime claim.
The re-instated amendments are 30 United States Code 921(c)(4) and 30 U.S.C. 932(l); and they are contained in Section 1556 of the Patient Protection and Affordable Care Act and apply to claims filed after Jan. 1, 2005, that are pending on or after March 23, 2010.
The final rule addresses the automatic entitlement of certain survivors and the 15-year entitlement presumption as it applies to miners’ and their survivors’ claims. In addition, the rule eliminates several unnecessary or obsolete provisions in accordance with Executive Order 13563.
Stat News also tell the stories of black lung survivors who talk about just how impossible it was to receive benefits, ” ‘You couldn’t ever win back then,’ said Sue Toler, a coal miner’s widow in Huntsville, Tenn., of claims for black lung benefits. ‘It didn’t matter what kind of evidence you had.’ “ Phil Smith, a spokesperson for the United Coal Workers of America said it was “almost impossible . . . The vast majority of people were denied benefits. People would take these cases through the black lung court system and they would be denied because the companies could sow the shadow of a seed of a doubt.”
Stat News goes on to explain how the ACA changed things:
The Affordable Care Act changed that. Under “Miscellaneous Provisions” is a small section sponsored by a self-proclaimed “child of the Appalachian coalfields,” the late West Virginia Democratic Senator Robert Byrd.
The Byrd Amendments shifted the burden of proof from the miners onto the mining companies. If a miner has spent 15 years or more underground and can prove respiratory disability, then it is presumed to be black lung related to mine work, unless the company can prove otherwise.
“Often the person whose job it is to do the convincing loses,” said Evan Smith, a lawyer for the nonprofit Appalachian Citizens’ Law Center, who represents many miners affected by black lung. That change had a significant impact: In 2009, 19 percent of claims for black lung benefits were successful; in 2015, that percentage had jumped to 28.
And now, faced with the reality of Trump’s dangerous campaign rhetoric, at times at odds with itself, the coal miners of Appalachia are left wondering, “who really has my back?”
I think we all know who doesn’t. And unfortunately – in four years whether or not Trump scammed the hell out of them isn’t going to matter…