Good news on health care

 It’s not obvious from the title, but the recently passed Inflation Reduction Act (IRA) is the biggest federal health care legislation in a dozen years, one that will directly benefit over one in four West Virginians.

For starters, the law permanently extends the Black Lung Excise Tax, which provides benefits for over 4,400 West Virginia families impacted by that terrible disease caused by breathing coal dust. Nationwide nearly 26,000 families will benefit, including over 18,000 primary beneficiaries and around 7,000 dependents. According to the Brookings Institution, Black Lung is most prevalent in central Appalachia, with 20.6 percent of miners affected. 

In the late 1960s, a historic grassroots movement spearheaded by West Virginia coal miners and supporters brought the issue to national attention and won federal legislation to establish the benefit, although its funding was in jeopardy in recent years until the bill was passed.

The IRA also extends Affordable Care Act (ACA) marketplace subsidies for three years for people who purchase insurance plans on the exchange, which will help around 23,000 West Virginians and over 14 million people nationwide.  

People who buy care through the ACA marketplace have traditionally been the hardest group to find health care since they aren’t covered by employer-based insurance and don’t qualify for public programs such as Medicare, Medicaid, Tri-Care, or VA benefits. Thanks largely to ACA subsidies and Medicaid expansion, the number of uninsured Americans reached an all time low of eight percent this summer: still too high but a big improvement.

The biggest impact of the bill will be on people receiving Medicare, which covers over 440,000 West Virginians and around 64 million Americans, although these changes will be rolled out over time. 

According to the Kaiser Family Foundation, in 2023 insulin will be capped at $35 a month on the Medicare Part D prescription drug program; drug companies have to offer rebates if prices increase above inflation; and cost sharing for adult vaccines under Part D and Medicaid will be eliminated.

The Medicare diabetes cap is a big deal, although a ruling by the senate parliamentarian blocked its application to private insurance. According to the American Academy of Family Physicians, which supported several IRA medical provisions, “More than 37 million Americans have diabetes, and an estimated one-quarter of people with diabetes in the United States ration their insulin due to costs. In 2021, U.S. diabetes deaths exceeded 100,000 for the second consecutive year.” The WV Department of Health and Human Resources estimates that 240,626 West Virginians have that disease with undiagnosed cases 65,210.

In 2024, the IRA caps Medicare premium increases to six percent a year through 2030; eliminates a part D co-pay for catastrophic coverage; and expands eligibility for the low-income Part D subsidy to 150 percent of the federal poverty level. In 2025, it caps drug costs for Medicare beneficiaries at $2,000 per year. And between 2026 and 2029, it will negotiate costs for an increasing number of expensive medicines each year.

While health care is only part of the IRA, which also addresses climate change and tax fairness, those are significant steps in the right direction and Senator Manchin was instrumental in sealing the deal. Of course, no legislation is perfect. Lots of West Virginians, myself included, worked hard on what would become the IRA for the last year or so. We didn’t get all we wanted and got some of what we didn’t, but there are still things to celebrate.

(This ran as an op-ed in the Charleston Gazette Mail last week.)

A yo-yo year

 Lots of people I know, myself included, spent a lot of time over the last year trying to get something across the line in terms of a federal reconciliation bill. We started with high hopes and saw things go off the rails on more than one occasion. 

Now, a possible new bill could be voted on very soon, one largely negotiated by a certain senator from West Virginia who has been front and center throughout the process. Although there are plenty of things in the bill not to like, and some things we wanted didn't make it, this is the first major federal legislation to address climate change, while also preserving health care benefits for millions, reducing prescription drug prices, and fixing Black Lung funding.

I'm pleased and proud that this action alert in support of the legislation is at the top of the AFSC webpage.

The United Mine Workers union has also come out strong in support of the Inflation Reduction Act. The release reads in part:

“We are very pleased that Senator Joe Manchin (D-W.Va.) and Majority Leader Chuck Schumer (D-N.Y.) were able to come to an agreement on legislation that includes full and permanent funding of the excise tax that funds the Black Lung Disability Trust Fund. This will give victims of this insidious disease, their families and their survivors some peace of mind that the benefits they so desperately need will never be reduced.

“Senator Manchin never wavered in his commitment to secure the funding for this program, and he delivered. Thousands in the coalfields owe him yet another debt of gratitude, and the UMWA will never forget his dedication to getting this done.

“There is more to do regarding Black Lung, starting with the promulgation of a final rule to limit silica dust exposure in coal mines. We also must examine the entire Black Lung benefits system to make it more inclusive for victims, more efficient in the awarding of benefits, and to ensure its long-term viability in the face of a declining coal industry. The UMWA stands ready to meet with all stakeholders – victims and their families, labor, and industry – to work on solutions to these issues.

“We are also pleased to see that provisions were included in the IRA that will extend tax credits to renewable energy supply chain manufacturers that build plants in the coalfields, which will be a big step toward providing good jobs to these distressed communities. The enhanced tax credits for carbon capture and storage included in the legislation will also be a boon for coalfield jobs. We urge swift passage of this legislation by Congress.”

Now it looks like all eyes are on Senator Sinema. It's nice for once not to have to worry about someone from West Virginia breaking the deal. It would be nicer to finally get this one done.

All talk?

 It's been a long and disappointing struggle over the last year to try to get WV Senator Joe Manchin to take positive action on human needs and climate. Now we're getting down to the wire. So many people have been let down, perhaps especially kids and parents who at least so far seem to have lost out on help with child care, paid leave, the refundable Child Tax Credit and more.

If there's any chance of salvaging anything in the federal budget reconciliation process, it might come down to coal miners. The federal Black Lung excise tax provides modest benefits for people struggling with that terrible disease--and it expired last year, leaving the long-term stability of the program in question. Extending it was part of the Build Back Better bill that got tanked by Manchin in December.

In West Virginia, politicians traditionally pretend to care about coal miners, although it seems like most of the real love goes to coal companies. Given all that rhetoric and theater, it seems like this is one thing that has to get across the line, which could open the way for more.

Yesterday, the National Black Lung Association held a press conference at the statue honoring miners at the state capitol calling on Manchin to come through for miners and their families via the reconciliation process. Fortunately, the press showed up, including the Charleston Gazette-Mail, WV Public Broadcasting, WV MetroNews, and even The Hill. More national stories may be in the works.

It seems like there is real pressure now for actions to match words. But I've been wrong before.

AFSC WV statement on Senator Manchin and Build Back Better

 CHARLESTON, WV (December 20, 2021) Over the weekend, West Virginia Senator Joe Manchin announced on Fox News that he would not support the Build Back Better act. This comes after months of debate over the provisions in the bill, which would help families with childcare, improve the U.S. response to climate change, and strengthen the social safety net. The proposed legislation would also provide needed funding for Black Lung benefits.

The West Virginia program of the American Friends Service Committee (AFSC) – a Quaker organization active in the state for a century – issued the following statement calling on Manchin to change his position:

“A century ago, Quaker volunteers began working in solidarity with the people of West Virginia. There was severe economic hardship in the coalfields, with child poverty and hunger being key issues. Sadly, and perhaps incredibly, those issues are still very much alive in West Virginia, and we are still in the struggle to alleviate these challenging circumstances for people in our community.

During the 1920s and and1930s, AFSC administered direct relief to families in West Virginia and advocated for federal New Deal legislation to reduce unnecessary human misery, which transformed U.S. society. From the 1970s onward, AFSC accompanied and advocated for justice for coal miners and other workers, Black people, women, children, people in poverty, and other marginalized communities.

On many occasions, AFSC staff and volunteers collaborated with then legislator, later Governor, and now Senator Joe Manchin on state and federal issues ranging from the minimum wage and fair taxes to coal mine safety and preserving the gains of the Affordable Care Act.

We have also witnessed firsthand the better angels of our Senator’s nature in the compassion he has shown for victims of natural and human disasters. From the 1968 Farmington mine disaster, in which he lost an uncle, to the Aracoma, Sago and Upper Big Branch mine tragedies in the 2000s and beyond, Senator Manchin has shown himself to be compassionate and responsive.

Thus, we are deeply saddened to learn that Senator Manchin has withdrawn support from the proposed Build Back Better Act. Many in West Virginia have worked tirelessly to advocate for an opportunity to pass this life-changing piece of legislation. The Build Back Better Act would be as positively transformative as the New Deal in dramatically reducing child poverty and helping working families negotiate the duties of family and work. The Build Back Better Act would also address the existential threats of climate change and the need for a just economic transition for the people of West Virginia towards a more prosperous, sustainable, and less extractive and exploitive economic future.

We are still hopeful. AFSC is a diverse organization committed to the deeply held view that there is “that of God” in every person. It is not too late for Senator Manchin to return to his commitments, take a bold and needed step in this pivotal moment, and support prompt enactment of these measures.

We are holding out hope that our Senator still has some compassion for the hundreds of thousands of West Virginians and millions of people who would benefit from the Child Tax Credit, childcare support, improved health care, and immigration relief. As an organization with a global footprint, we also hope the Senator has compassion for the billions of people worldwide who might benefit from addressing climate change, an existential threat to us all.

We urge our Senator to recommit himself to negotiating the passage of genuinely transformative federal legislation that would dramatically reduce human suffering in West Virginia, the United States, and worldwide.”

###

The American Friends Service Committee is a Quaker organization that promotes lasting peace with justice, as a practical expression of faith in action. Drawing on continuing spiritual insights and working with people of many backgrounds, we nurture the seeds of change and respect for human life that transform social systems.

Calling all politicians who pretend to care about miners: prove it

Politicians around the country have shed a lot of crocodile tears for coal miners and their families in recent years. I suspect that many of these have been theatrical in nature.

Now there are a couple of chances to find out who’s for real and who isn’t. Two bills have been introduced in Congress that could make a real difference for coalfield communities.

One is Senate Bill 27, the American Miners Act of 2019, introduced by Sen. Joe Manchin, D-W.Va., and supported by Sen. Shelley Moore Capito, R-W.Va.

It’s basically about keeping promises.

The bill would modify the federal Surface Mining Reclamation and Control Act of 1977 to allow funds to be transferred to the 1974 United Mine Workers Pension Plan, which was originally created by President Harry Truman in 1946 to ensure health and pension benefits to the miners who put themselves at risk for decades to build the country’s industrial might and raise the standard of living. It would impose no new costs to taxpayers.

The UMWA pension fund has taken hits over the years. One of these was the most recent recession, which hit hard around 10 years ago. Even worse has been the steady stream of corporate bankruptcies.

(Sad to say but, these days, it seems like it’s easier for coal companies to dodge paying promised benefits than it is for an ordinary worker to get relief from student loan debt.)

According to Manchin, “In the past two years, contributions into the plan have dropped by more than $100 million, leaving less than $25 million per year still coming into it. The average pension is $600 per month, modest by most standards, but still critical to the 87,000 beneficiaries who depend on it.”

Capito told WV MetroNews: “These retirees are not getting rich on their pension plans and they are not taking lavish expenditures. Without this monthly benefit, many of them would be living on the edge of poverty, if they are not already.”

The bill would also prop up funding for black lung benefits for miners and their families by extending the Black Lung Disability Trust Fund tax for 10 years. This step is urgently needed because the problem is getting worse.

According to a 2018 NPR news report, “One in five working coal miners in central Appalachia who have worked at least 25 years now suffer from the coal miners’ disease black lung ... . It’s the highest rate in a quarter-century and indicates that the disease continues to afflict more miners in Kentucky, Virginia and West Virginia.”

In 2017, the U.S. Department of Labor estimated that black lung has killed more than 76,000 people since 1968. Unfortunately, we can only expect those numbers to increase in the future. In 2018, more than 25,000 miners and dependents received benefits from the Black Lung Disability Trust Fund.

Another bipartisan measure that could benefit coalfield communities is the RECLAIM Act (House Resolution 2156), which stands for “Revitalizing the Economy of Coal Communities by Leveraging Local Activities and Investing More.”

RECLAIM would release money from the Abandoned Mine Land Reclamation Fund to help communities clean up some of the damage caused by mining—and its decline. It could also help put former miners and other dislocated workers back to work.

Both of West Virginia’s senators have supported the principles of the RECLAIM Act. A version of the bill cleared the House Natural Resources Committee on May 1.

These bills obviously aren’t a total fix to undo the harm done to workers, communities and environments over the last 100 or so years, but they would be steps in the right direction. And a promise is a promise.

(This ran as an op-ed in the Charleston Gazette-Mail.)

Annals of hypocrisy: shafting coal miners

If you've been following the news in West Virginia over the last few months, you are no doubt aware of the legislative coup that shook up the state supreme court. Two of the justices appointed to fill....uhhh...vacancies were former legislator and congressman Evan Jenkins and former state house speaker Tim Armstead.

Over the years, both men, especially Jenkins, made much hay about their alleged love for coal miners and their heroic stance against the "war on coal."

Well, their most recent decision will actually make it harder for coal miners to qualify for black lung benefits.

I mean, golly, who could have seen that coming?

This is what happens...

Sometimes it's hard not to say "No ****!" This might be one of those times. There have been a number of reports about how residents of the coalfields, many of whom supported he-who-must-not-be-named, are now in danger of losing black lung benefits.

Aside from black lung, the depressed areas of Kentucky and West Virginia are among those that have benefited the most from Medicaid expansion under the Affordable Care Act. Both states have seen huge drops in the number and percent of uninsured.

All that is up for grabs now, and much of it is likely to go down the drain. A major struggle is starting to take place to try to ensure that the ACA is not repealed without being replaced.

I think we may need a new rule: before sticking it to the man, we need to figure out exactly which man we're talking about. This time around, it seems like the man who got stuck is the one who works. The woman too.

A major catch

I could be wrong, but The Front Porch program/podcast on WV Public Broadcasting, may actually be getting respectable. This week, we had an actual US senator, WV's Shelley Moore Capito. We talked about black lung, health care, broadband and the new political era here.

Prophetic words. And others

I'm in the middle of a research project on the timely subject of why WV is poor. Along the way I rediscovered this prophetic 1884 report from the WV Tax Commission, which was alarmed by how quickly out of state business interests were gaining control of the state. Here's how it ended:

The wealth of this State is immense; the development of this wealth will earn vast private fortunes far beyond the dreams even of a modem Croesus; the question is, whether this vast wealth shall belong to persons who live here and who are permanently identified with the future of West Virginia, or whether it shall pass into the hands of persons who do not live here and who care nothing for our State except to pocket the treasures which lie buried in our hills? 

If the people of West Virginia can be roused to an appreciation of the situation we ourselves will gather this harvest now ripe on the lands inherited from our ancestors; on the other hand, if the people are not roused to an understanding of the situation in less than ten years this vast wealth will have passed from our present population into the hands of non-residents, and West Virginia will be almost like Ireland and her history will be like that of Poland. 

The rest is here and it's well worth a look. Golly gee, wouldn't it be terrible if they were right?

Slightly off topic, here's an interesting post from Ken Ward's Coal Tattoo about Donald Trump, black lung and coal. Here's an excerpt from an interview Trump gave back in 1990:

I like the challenge and tell the story of the coal miner’s son. The coal miner gets black-lung disease, his son gets it, then his son . If I had been the son of a coal miner, I would have left the damn mines. But most people don’t have the imagination–or whatever–to leave their mine. They don’t have “it.”

Imagine the outrage if something like that came from the mouth of other candidates...

What would Dante say?

The Gentle Reader may recall an expose by the Center for Public Integrity and ABC News a while back about how coal companies, their lawyers, and a lab at Johns Hopkins routinely collaborated to deny miners black lung benefits.

According to news reports, Hopkins has terminated that program, which will forever be a scar on the institution. It should never have existed to start with. I wonder how many miners died before getting the benefits they deserved

One doctor there, and I use the term loosely, is said not to have found a single case of black lung in the more than 1,500 cases he investigated. Since then, the federal government has informed around 1,100 miners that they were wrongly denied benefits.Of course, they only informed the ones who still lived.

All of which makes me wonder what circle in Hell Dante would assign to those responsible. I'm guessing it would be somewhere in Malebolge, the eight circle, which is reserved for fraud, or maybe even the icy ninth, which is reserved for those who betray. I think it's a safe bet that he'd put them way down.

Hypocrisy, skulduggery and one to watch

Perhaps the Gentle Reader will recall the crocodile tears shed by political candidates who oozed with compassion for miners and were eager to fight against the alleged "war on coal."

(The winning state candidates who did this demonstrated their sincerity in the last legislative session by rolling back some coal mine safety measures despite the firm opposition of the United Mine Workers.)

Meanwhile, at the federal level, the only member of WV's congressional delegation to support a bill making it simpler for deserving miners to get black lung benefits is Joe Manchin. This would be another put up or shut up moment for people who apparently have little inclination to do either.

NOW SKULDUGGERY. Workforce WV just completed a survey mandated by the legislature last year to calculate prevailing wages for public construction projects. It looks like state legislative leaders really wanted to kill prevailing wage and drag down conditions for working people all along.

NOW ONE TO WATCH. I'm referring of course to the trial of former Massey Energy CEO Don Blankenship.

A little justice

Last week, I blogged about recent reports by ABC News and the Center for Public Integrity about how prominent law firms, universities and hospitals were devoted to cheating coal miners out of deserved black lung benefits.

I was delighted to learn that Johns Hopkins suspended a black lung program  that thrived by depriving Appalachian coal miners of benefits who were dying from that disease.

Some of the miners denied benefits were proven to have the disease when they were autopsied.

Whatever happened to Hippocrates idea of doing no harm?

Yanking the program was a welcome step, but it's just a tiny bit of what deserves to happen.

Four for the road

Paul Krugman shows up quite a bit at Goat Rope, but today's op-ed about a war on the poor is better than usual and worth a close look.

SPEAKING OF WHICH, one in five West Virginians, along with millions of people around the country, will face cuts in SNAP benefits (aka food stamps) today.

BLACK LUNG. There's an old saying that if you can't say something nice about somebody, don't say anything at all. Here's an article about a law firm that is really good at keeping sick miners from getting black lung benefits. Nuff said.

IT'S NOT ALL BAD. Workforce WV got a federal grant to provide paid training for displaced miners. It's not enough, but it's a step in the right direction.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Infernal real estate

I'm sure my beloved Dante enjoyed parceling out real estate in Hell for the first canticle of his Divine Comedy. Some days, I'd kind of like to hand out the real thing. Some of the prime lots would go to people who cheated sick coal miners out of the black lung benefits they deserved.

ROBIN HOOD. Here's  an idea that makes way more sense than austerity.

IT'S NOT ALL BAD. Here are some creative ways West Virginians are promoting wellness in their communities.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Annals of hypocrisy

The coal industry continued its 5 year long hissy fit in Washington yesterday, where it asserted that the troubles of the industry have nothing to do with cheap natural gas,cheap western coal or the very real threat of climate change but rather can be conveniently blamed on the black guy.

But a lot of the same industry voices claiming to be the protectors of miners are the same ones who cheat them out of black lung benefits. Kudos to the Center for Public Integrity for shedding light on evil.

On becoming a troll

People who view news stories online have no doubt come across the right wing comments that are written by  anonymous people who lurk around these sites the way carp hang out at lakeside bait shops. Such people are called trolls in the parlance of our times.

Sometimes reading troll writing can be infuriating. There have been times when I dreamed of challenging this or that one to a no-rules cage match, although I realize such a move would likely do little to advance my status as someone working in a Quaker organization. Sometimes troll lit is just kind of funny in a sad way.


But lately, as I've noted when the occasion arises, some people have joined the fun by parodying trollish comments on the web. I finally decided it you can't beat join em and plan on out-trolling the trolls whenever the opportunity arises.


My first effort appeared in an online editorial about climate change, a subject always ready to enrage coal-groveling Whackadoodles. Here's what I came up with:

Yeah, anyone who believes in climate change hates America and freedom and probably Jesus too. Science is stupid. So is the environment. I mean, if animals eat each other and go to the bathroom in nature, why should we care about it.

I'm kinda proud of that one. It's a little over the top but comes closer than you would probably like to believe to real things people say on line. As the late great Don Marsh, longtime editor at the Charleston Gazette, sometimes said, "Vox populi, vox wuffo!"

SPEAKING OF TROLLS, they'd really go off on this.

BLACK LUNG. Here's the next installment in NPR's series and more from the Gazette.

HE THINKS TOO MUCH. Such men are dangerous.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Turkeys meet world

I may have mentioned a while back that we have something on the order of 22 baby turkeys on Goat Rope Farm. They've spent the first few weeks of their lives in a little enclosure.
Now that they're bigger, we decided it was time to let them out in the bigger world. They filed out like a bunch of schoolkids.

Their first action as free birds was to start chowing down on ragweed.

Who would have thought that this plant would turn out to be turkey crack?

THINGS PEOPLE LIKE ABOUT HEALTH CARE REFORM. The problem is, they have to know about it first.

BLACK LUNG never really went away, but now it's back with a vengeance.

THIS PERSON MUST HATE FREEDOM. He's writing about climate change.

GOAT ROPE ADVISORY LEVEL: ELEVATED

TYGER! TYGER!

What immortal hand or eye...?

The poems from William Blake's Songs of Innocence and of Experience have the ability to speak to all kinds of people and to people of all ages.

When El Cabrero's daughter was only a little thing, she had memorized most of this one:

Tyger! Tyger! burning bright
In the forests of the night
What immortal hand or eye
Could frame thy fearful symmetry?

In what distant deeps or skies
Burnt the fire of thine eyes?
On what wings dare he aspire?
What the hand dare seize the fire?

And What shoulder, and what art,
Could twist the sinews of thy heart?
And when thy heart began to beat,
What dread hand? and what dread feet?

What the hammer? what the chain?
In what furnace was thy brain?
What the anvil? what dread grasp
Dare its deadly terrors clasp?

When the stars threw down their spears,
And watered heaven with their tears,
Did he smile his work to see?
Did he who made the lamb make thee?

Tyger! Tyger! burning bright
In the forests of the night,
What immortal hand or eye
Dare frame thy fearful symmetry?

Alas, between childhood and adolesence, something happened. When I asked her about the poem in the midst of her "cheerleader rage" years (a term she coined), this is what she came up with:

Tyger Tyger burning bright
In the forest of the night
I wish I may I wish I might
Get the wish I wish tonight...

In the spirit of the scientific method, of which Blake wasn't too fond, I can't say the cheerleading caused the mutation. But the correlation is there...

BLACK LUNG CASES INCREASE. This article by Ken Ward came out last week:

Black lung disease rates among U.S. coal miners have doubled in the last decade, according to new federal government data released this week.

Occupational safety experts say the figures reveal a troubling reversal from a quarter-century of success in fighting the deadly disease.

Ten years ago, about 4 percent of miners with 25 or more years of experience were diagnosed with the disease; now the figure is 9 percent.

Between 1993 and 2002, nearly 2,300 West Virginia miners died of black lung. West Virginia recorded the highest age-adjusted black lung death rate nationwide during that period, according to NIOSH reports.

The United Mine Workers union is seeking tougher regulations on underground air quality.

UPDATE ON THE LOGAN CASE More charges are likely to be filed against those accused of kidnapping, torturing and sexually abusing Megan Williams.

THE MORAL SENSE--Is it innate? And what does it consist of? Here's an interesting article about this scientific controversy.

CHIP VS. VETO. The House and Senate are nearing a compromise on expanding the Childrens Health Insurance Program (CHIP), although a veto threat from the Bush administration still hangs in the air.

ON THAT NOTE, here's an update on upcoming votes in Congress from the Coalition on Human Needs.

ONE MORE THING. Congratulations and a thank you to WV Governor Joe Manchin, who was one of 30 governors to sign on to a letter to the federal Department of Health and Human Services in support of the CHIP program.

GOAT ROPE ADVISORY LEVEL: ELEVATED