<p><span style="font-weight: 400;">Take Barry Shrewsbury of West Virginia, for example: He worked in mining as a younger man, and presently, at age 62, has difficulty breathing and going about basic daily tasks, like showering and shopping. For his oxygen tank and medical care, Shrewsbury relies on a federal fund for miners with black lung disease, called The Black Lung Disability Trust Fund.</span></p><p><div data-conversation-spotlight=""></div></p><p><span style="font-weight: 400;">The fund is currently under threat of dissolution. Increasing debt and cuts to contributions from the coal industry scheduled for the end of 2018 put it at risk of insolvency, according to two sources from the </span><a href="https://www.gao.gov"><span style="font-weight: 400;">U.S. Government Accountability Office (GAO)</span></a><span style="font-weight: 400;"> in an interview with Reuters.</span></p><p><span style="font-weight: 400;">With black lung hitting rates unseen in decades, this is particularly dangerous as this could shift some of the financial burden to taxpayers, potentially slashing the benefits for recipients. The fund has already reluctantly </span><a href="https://www.cnn.com/2018/06/04/health/black-lung-fund-report/index.html"><span style="font-weight: 400;">borrowed more than $6.5 billion from the U.S. Treasury</span></a><span style="font-weight: 400;"> to finance the program, according to the </span><a href="https://home.treasury.gov"><span style="font-weight: 400;">Treasury Department</span></a><span style="font-weight: 400;">. About half of the fund's revenue is currently allocated toward repayment of that debt.</span></p><p><span style="font-weight: 400;">Kirsten Almberg, an assistant professor of environmental and occupational health at the University of Illinois at Chicago, who wrote a grim analysis of </span><a href="https://www.dol.gov"><span style="font-weight: 400;">Labor Department</span></a><span style="font-weight: 400;"> data, remarks, “This is history moving in the wrong direction.” Her analysis revealed that almost half the 4,679 benefits claims from miners with the most treacherous form of </span><a href="https://www.npr.org/2012/07/10/155981916/black-lung-rule-loopholes-leave-miners-vulnerable"><span style="font-weight: 400;">black lung were made in the years since 2000</span></a><span style="font-weight: 400;">.</span></p><p><span style="font-weight: 400;">Former miners and health professionals in the region believe the resurgence of the disease is due to longer hours in deeper reaches of the old mines, in addition to slack safety measures and newer machines that can now puncture through layers of rock.</span></p><p><span style="font-weight: 400;">Presently, the fund covers medical expenses and monthly living expense payments for over 15,000 people, according to a Congressional report published this year. It also pays benefits to miners severely disabled by black lung in cases where no applicable coal company can directly provide support, like when a company bankrupts, which is fairly common given the advent of wind and solar power. About 2,600 medical claims were taken from companies and given to the fund in 2017 due to bankruptcies, according to a </span><a href="http://democrats-edworkforce.house.gov/imo/media/doc/GAO%20REPORT%20-%20BLACK%20LUNG%20BENEFITS%20PROGRAM%20(JUNE%202018).pdf"><span style="font-weight: 400;">2018 Congressional report</span></a><span style="font-weight: 400;">.</span></p><p><span style="font-weight: 400;">Yet, the coal industry is lobbying Congress to promote the scheduled tax reduction under the belief that that payments are too high for mining companies and the fund has seen abuse from undeserving applicants.</span></p><p><span style="font-weight: 400;">Medical experts describe the disease as an incurable illness caused by the inhalation of coal dust, and explain that it is easy to distinguish from other diseases, using x-rays. Dr. David Blackley of the </span><a href="https://www.cdc.gov/niosh/"><span style="font-weight: 400;">National Institute for Occupational Safety and Health</span></a><span style="font-weight: 400;">, an offshoot of the Center for Disease Control and Prevention (CDC), asserts that “it is not caused by smoking.”</span></p><p></p><p><span style="font-weight: 400;">Bruce Watzman, head of regulatory affairs for the </span><a href="https://nma.org"><span style="font-weight: 400;">National Mining Association</span></a><span style="font-weight: 400;">, believes the fund is subsidizing previous or current smokers. He bases his view on “discussions with those administering this program for companies,” though he, himself, has performed no research on the misallocation of benefits. He later </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/2523477"><span style="font-weight: 400;">cited a study from 1989</span></a><span style="font-weight: 400;"> by the University of Louisville School of Medicine, which examined 1,000 black-lung benefit applications and found that coal miners judged “potentially eligible” for benefits smoked at higher rates than those who did not qualify.</span></p><p><span style="font-weight: 400;">Jim Werth, the black lung clinic director at Stone Mountain Health Services in St. Charles, Virginia, disagrees with the assertions that the fund is covering applicants who do not technically qualify or are otherwise ineligible. He claims the process in itself makes qualification difficult, especially with barriers like coal companies hiring physicians to challenge medical test results. In the meantime, many of these individuals are unable to work and paralyzed by medical expenses.</span></p><p><span style="font-weight: 400;">To qualify for benefits, a miner must first apply to the Department of Labor. Next, the application is screened based on medical and employment documentation. The Department of Labor then attempts to find a responsible coal company to fund the costs, and in doing so must consider all potential causes of an applicant’s lung problems prior to awarding benefits. This yields an approval rate of about 20 percent, or at least was the case in 2017.</span></p><p><span style="font-weight: 400;">Coal companies are </span><a href="https://revenuedata.doi.gov/how-it-works/coal-excise-tax/"><span style="font-weight: 400;">taxed $1.10 per ton on underground coal production</span></a><span style="font-weight: 400;"> to finance the fund, but the tax will revert to the 1977 level of $.50 by the conclusion of 2018 if Congress does not extend the current rate.</span></p><p><span style="font-weight: 400;">An extension of the current excise coal tax failed earlier this year after the National Mining Association lobbied Republican House leadership against it, though discussion will likely return following the release of the GAO report, which was requested back in 2016 by Democratic Congresspeople Bobby Scott (D-VA) and Sander Levin (D-MI). It has undergone review by the Trump administration, who have focused on deregulating the coal industry.</span></p><p><span style="font-weight: 400;">For recipients like Barry Shrewsbury, “the benefits are a lifeline."</span></p>
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