Alexandra Kanik | Ohio Valley ReSource

As Congress considers repealing the Affordable Care Act, health professionals in Kentucky, Ohio, and West Virginia grapple with what that might mean for a region where many depend on the law for access to care. This occasional series from the ReSource explores what’s ahead for the Ohio Valley after Obamacare. See more stories here >>


Retired coal miners face a one-two punch to their health benefits that could leave many of them in the lurch. A repeal of Obamacare and the expiration of miner’s health protections could make it hard for any coal retiree to get health care.

Ohio Valley retirees have been meeting one-on-one with congressional leaders to talk about the risks to their benefits. Some provisions of the Affordable Care Act are especially important to miners. The so-called Byrd Amendment deals with benefits for miners suffering from black lung, and miners hope it will be restored if the Act is repealed. Miners are also concerned about the Act’s pre-existing condition provision.

brandon-mackie-2Howard Berkes, NPR

Mackie Branham views a lung X-ray with Dr. James Brandon Crum, who was among the first physicians to note an uptick in black lung diagnoses.

United Mine Workers communications director Phil Smith said the nature of the work makes every retired miner a “walking basket of pre-existing conditions.”

“If they don’t have the health care that they were promised and the miner’s protection act doesn’t pass, and the ACA is out the window, then nobody’s going to insure them,” Smith said.

Smith said the union hopes the miner’s protection act will pass before the end of April, when 22,600 miners, widows, and beneficiaries could lose their health and pension benefits.

Without those guarantees, miners might have to look for health insurance elsewhere. Many of them have higher rates of cancer, heart disease and musculoskeletal injuries that make it harder to get insurance. Smith is worried miners won’t be able to afford care. He said if those retirees wait until they are seriously ill and then seek care at emergency rooms, as many uninsured patients do, rates for those that are insured could go up.

“These are people that don’t have a whole lot of money to start with, exist on a small pension and small social security check,” Smith said.

Uncompensated care spending, which is the cost of caring for the uninsured, has gone down since the ACA took effect. With small pensions averaging about $500 a month, miners will have to make some tough decisions on what to pay for.