A new government report says that the federal black lung trust fund that helps sick and dying coal miners pay living and medical expenses could incur a $15 billion deficit in the next 30 years. That's if a congressionally mandated funding cut occurs as planned at the end of the year.

The cut in the funding formula comes as NPR has reported and government researchers have confirmed an epidemic of the most advanced stages of black lung, along with unprecedented clusters of the disease in the central Appalachian states of Kentucky, Virginia and West Virginia.

The report from the Government Accountability Office reviewed the viability of the federal Black Lung Disability Trust Fund, which paid out $184 million in benefits in fiscal year 2017 to 25,700 coal miners suffering from the fatal mine dust disease and their dependents.

A tax on coal companies supports the fund, but that tax is set for a 55 percent cut at the end of 2018, even as the fund's debt exceeds $4.3 billion and demand for benefits is expected to grow.

"You have to address the fact that the serious forms of black lung appear to be increasing and that may put even more strain on the trust fund," says Rep. Bobby Scott, D-Va., the ranking Democrat on the House Committee on Education and the Workforce.

"The last thing you want to do ... is to reduce the revenue," adds Scott, who requested the GAO report. "That will inevitably ... put pressure on the idea that we should reduce the little benefits that they have."

Miners with certified cases of black lung receive $650 to $1,300 a month for living expenses. They also receive medical care directly related to their disease, which averaged $6,980 per miner last year.

"We're dying off like crazy right now," says Sheralin Greene, 57, who mined coal underground for 20 years in Harlan County, Ky. Black lung has sapped her ability to walk around her small farm, do chores at home, or even sleep, without paralyzing coughing fits that last 15 minutes or more. She receives payments and medical care from the federal trust fund.

"It's a terrible disease," Greene says, as tears glaze her eyes. "It affects your heart. It affects your family, your livelihood and everything."

At the current rate, the coal tax collects more than enough money to cover miners' benefits — $450 million in FY 2017. But that wasn't always the case. The fund had to borrow money to pay for benefits in the past, and that, plus interest on the loans, has put the fund deep in debt.

The only projection in the GAO report that results in zero debt, avoids borrowing more money for the fund decades into the future, and continues to pay benefits, requires a 25 percent spike in the coal tax, instead of cutting it as planned.

Increasing the tax or even leaving the current rate in place would burden the coal industry, says Bruce Watzman, an executive at the National Mining Association.

"The competition among fuels for electric generation is intense and a couple cents a kilowatt hour makes a difference in the fuel source that's generating the electricity," Watzman adds.

Watzman favors congressional action that forgives some or all of the fund's debt. But even with full debt forgiveness, the GAO still projects a deficit of $2.3 billion in 2050.

Forgiving the debt also shifts the costs of the black lung benefits program from coal companies to taxpayers, according to Treasury officials who were consulted by the GAO. They "noted that the costs associated with forgiving Trust Fund interest or debt would be borne by the general taxpayer since Treasury borrows from taxpayers to lend to the Trust Fund as needed," the report says.

"Coal operators caused this problem, and they are the ones who should be responsible for funding the compensation these workers receive," says Cecil Roberts, international president of the United Mine Workers of America.

Coal companies buy insurance or self-insure for black lung and are the first held responsible for payment when miners are awarded benefits. But industry bankruptcies and the failure to secure enough insurance had mining companies paying just 25 percent of black lung benefits in FY 2017. The Trust Fund, which kicks in when coal companies can't pay, paid 64 percent.

The GAO's projections do not include the recent studies showing record-high rates of progressive massive fibrosis, the advanced stage of black lung, along with an increase in lung transplants due to black lung. A recent study by the National Institute for Occupational Safety and Health noted that lung transplants cost on average $1 million each and the rate of transplants for miners with black lung has tripled.

"It's not our fault that we got this disease," says former miner Sheralin Greene. "We did keep the lights on ... We were just trying to help America ... They better take care of the coal miners."

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

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