It is indisputably better to be a coal miner today, in 2015, than in 1969—the year in which Congress passed the Federal Coal Mine Health and Safety Act.

Generally known in simpler terms as “the Coal Act,” the law precipitated the establishment of a number of crucial regulatory bodies, including the Mining Safety and Health Administration (MSHA)—a sort of Occupational Safety and Health Administration (OSHA), tailor-made for underground and surface-mining operations.

The act itself, in addition to creating this regulatory framework, laid down a set of nationwide health and safety standards for US miners, who, prior to, suffered some of the highest work-related mortality rates in the country.

The passage of the Coal Act, in conjunction with the establishment of MSHA, is generally credited with the precipitous decline in prevalence of coal worker’s pneumoconiosis (CWP, or “black lung”) between 1970 and 1995. This is an important distinction, because while life for the average coal miner today may be measurably better than it was 1969, it is not necessarily so when compared to industry-wide conditions in 1995.

The rate of contraction for progressive massive fibrosis is as high now as it was in 1969.

In the two decades since, the Centers for Disease Control and Prevention (CDC) has identified a measurable uptick in cases of CWP among workers in America’s coal-mining “hotspots,” anchored in the more mountainous regions of Tennessee, Kentucky, and West Virginia. CWP, a pulmonary disease, is contracted primarily through prolonged exposure to coal and rock dust. The current limits detail a “permissible exposure limit of 2 milligrams per cubic meter of respirable coal mine dust,” according to the CDC.

“The cause of this resurgence in disease is likely multifactorial,” the CDC report notes. “Possible explanations include excessive exposure due to increases in coal mine dust levels and duration of exposure (long working hours), and increases in crystalline silica exposure.” The latter is attributable to an industry-wide shift toward what are called “thin coal seams”—smaller deposits with more frequent rock intrusions—increasingly popular now that richer seams have been all but tapped out. “Concomitant with this is the likelihood of increased potential for exposure to crystalline silica, and associated risk of silicosis, in coal mining,” the report notes, silicosis being another form of pneumoconiosis, colloquially known as “grinder’s asthma,” or “potter’s rot.”

It gets worse: according to a study compiled by the National Institute for Occupational Safety and Health (NIOSH), the rate of contraction for a particularly severe, incurable form of CWP—progressive massive fibrosis—is as high now in mining hotspots as it was just prior to the enactment of the 1969 Coal Act.

Not surprisingly, that’s a fact industry leaders would rather have kept quiet.

A 2013 report published by the Center for Public Integrity found that the country’s most prominent mining-law firm, Jackson Kelly LLC, “withheld evidence of black lung cases over the years, helping to defeat the benefits claims of sick miners.” According to the Center:

“The firm has shielded reports generated by doctors of its choosing when even they found the miner had black lung. Of 15 cases reviewed in detail by the Center—dating from the 1980s to the present—the firm withheld reports in at least 11. Jackson Kelly has argued, sometimes successfully, that there is nothing improper about its approach, saying it submits evidence that support its case.”

Furthermore:

“The firm has allowed judges and consulting doctors to form opinions based on only the reports it chose to provide, even as it withheld other documents that cast doubt on what was in the record.”

And, finally:

“In the rare instances when a miner’s lawyer pushed for documents to be turned over and a judge commanded the firm to do so, Jackson Kelly, on behalf of its client, sometimes conceded the case, in theory rendering disclosure moot.”

Despite this, conservative politicians representing chunks of central Appalachia prefer to frame the federal government as the American coal miner’s arch-nemesis. “The Obama administration’s so-called ‘clean power’ regulation seeks to shut down more of America’s power generation under the guise of protecting the climate,” Kentucky senator and senate-majority leader Mitch McConnell wrote in an op-ed for local paper The Lexington Herald Leader on Mar. 3. “In reality, this proposed regulation would have a negligible effect on global climate but a profoundly negative impact on countless American families already struggling,” he added.

This type of rhetoric operates on two, major misconceptions. First, it suggests that “clean power” initiatives are the real reason for coal-industry decline. As highlighted in the aforementioned CDC findings, mining operations in central Appalachia and around the country have, of their own accord, turned to thin-seam mining. This indicates that the chief obstacle to large-scale mining operations is a general depletion in resources, not any major, national pivoting away from coal as a fuel source. In fact, coal still generates the majority of US power—39% in 2013, according to the US Energy Information Administration (EIA). And its top competitor isn’t government-sanctioned “clean power,” i.e. renewable energy or hydropower, but rather another private-sector fuel industry: natural gas.

Second, this rhetoric ignores a far more dire risk to Appalachian coal miners and their families: the return of CWP, and the accompanying financial struggles for those forced to care for bedridden, one-time breadwinners.

Clearly, there is a war on coal. A war on coal miners.

In fact, the Obama administration is doing arguably more for coal miners and their families than Republican senators, coal lobbyists, or the coal industry itself. Central Appalachia has seen some of the greatest increases in health-insurance enrollment between 2013 and 2014, thanks to the enactment of the Affordable Care Act. The rate of uninsured in Kentucky has cut in half, with a difference of -10% in West Virginia. Though the federal government isn’t doing as much as it could to identify and neutralize the points of origin for this CWP-comeback, it has provided some financial solace for stricken miners and their families.

Clearly, there is a war on coal. A war on coal miners. Exhibit A: the return of CWP, a disease thought wholly eliminated by the early 1990s. It’s a disease proven to be beatable with the implementation of careful workplace regulations, specially designed for the distinct conditions of the American mine. But as industry practices shift—specifically toward thin-seam mining—regulations must contort themselves accordingly. And what possible objection could there be to such a logical sequence of events?

According to an editorial in the Herald Leader, coal-industry leaders are challenging new limits on coal dust exposure and new protective measures in Appalachia because an increase in the contraction of black lung has yet to be documented in other US mining regions. This is well-treaded ground, the Herald Leader insists:

“A few years ago when another federal agency acted to protect Appalachia’s water from surface mining, the industry, along with the Beshear administration, sued, saying it was unfair to single out Appalachia for water protections not imposed elsewhere.”

It seems the coal industry can’t make up its mind: is Appalachia special, or isn’t it? When clean-energy initiatives ostensibly threaten the industry’s marketplace, lawmakers and lobbyists champion the plight of the hardscrabble miner lifestyle. The region is hailed as America’s powerhouse, an indispensable vertebra of American industry. Meanwhile federally mandated regulation, which has been empirically proven to save lives, is scapegoated for the natural decline of this finite-resource-dependent industry.

The distinction apparently lies between the resource and those that source it, the latter being far less valuable than the former. As the editors of the Herald Leader write, with unfortunate acuity, “The industry has long considered Appalachian miners expendable.”