Federal count of black-lung cases remains too low

Progressive massive fibrosis in underground miners 
 with more than 25 years experience (Coal Workers’ 
 Health Surveillance Program, Ky.,Va.,W.Va,1974–2015)

Cases of black-lung disease in Appalachia are still being grossly underreported, Jessica Lilly, Roxy Todd and Glynis Board report for West Virginia Public Broadcasting. Fewer than 100 cases have been officially reported in the past five years, but using data from 11 clinics in Virginia, West Virginia, Pennsylvania and Ohio, NPR's Howard Berkes found 962 cases in the past 10 years. Berkes found 186 cases in West Virginia at federally funded lung clinics since 2009, with numbers likely higher because some clinics reported only a few years' worth of data.

A 2016 report by the Centers for Disease Control and Prevention and Berkes's investigation found that black-lung disease is surging among Appalachian coal miners. Lawmakers responded in December to the report and investigation by asking the National Institute for Occupational Safety and Health, the U.S. Department of Labor Coal Mine Workers' Compensation Program and black-lung clinics funded by the Health Resources and Services Administration to work together do a better job obtaining counts of progressive massive fibrosis, the most progressive form of black lung.

The Patient Protection and Affordable Care Act "included special provisions that make it easier for coal miners to get black lung benefits," West Virginia Public Broadcasting reports. "Republicans introduced an alternative plan to replace Obamacare, but the first attempt failed to get support. Still, this might not be the end of America’s health care story. In a recent visit to West Virginia, Vice President Mike Pence vowed to keep fighting to repeal the ACA. If the ACA is repealed, gaining black lung benefits could become much more difficult for miners, effectively harming a group of people President Trump promised to protect."