Donald Trump wears a coal miner’s protective hat while addressing his supporters during a presidential campaign rally at the Charleston Civic Center on May 5 in Charleston, WV. (Photo by Ricky Carioti/The Washington Post)

Few pockets of America have been more fervently in support of President-elect Donald Trump than coal country. During his campaign, a hard-hat-wearing Trump made explicit appeals to miners, promising to reverse the recent and precipitous decline of the eastern coal industry centered in Appalachia.

Members of his party, meanwhile, have been reticent to help thousands of retired miners who could lose their health-care benefits on New Year’s Day.

About 12,500 former union miners and their families have been told their health benefits will lapse come Jan. 1, and an additional 10,000 are in danger of losing benefits at a later date. Congress could intervene to help the ex-miners, and a bipartisan group of lawmakers is pushing to do just that.

But Senate Majority Leader Mitch McConnell (R-Ky.), who represents a swath of coal country himself, has blocked previous efforts to address the crisis and has yet to commit to passing the legislation before Congress adjourns next month.

Most of the affected miners worked for various companies, including subsidiaries of industry giants such as Arch Coal and Peabody Energy, that were spun off a decade ago into Patriot Coal. That firm declared bankruptcy in 2012, and retiree benefits have since been slashed as declining coal companies have been unable to make required contributions to retiree pension funds.

Endangered pensions are all too common in declining U.S. industries, but miners argue that they are in a special position thanks to a 1946 strike-ending agreement that had the federal government explicitly agreeing to guarantee retirement benefits to the United Mine Workers of America.

“They’ve already paid for this,” said Phil Smith, the director of communications and governmental affairs for the UMWA. “They decided to take less in wage increases over the course of 40 years, so that their health care would be paid for, so that their pension would be paid for. The companies could make those contributions to the various funds instead of putting more money into their pockets.”

Those affected include former miners like Paul W. Eubank, 64, who retired after 32 years and now lives in Webster County, W.Va. His monthly income from his union pension and Social Security totals less than $2,800 a month to support him and his wife, who suffers from chronic back pain.

His union health plan covers most of his family’s medical costs; without it, he would be left to buy individual health insurance on a federally mandated exchange. While he could be eligible for tax credits, the cost of the plans on those exchanges, Eubank said, run upwards of $800 a month.

And once he turns 65 next year and becomes eligible for Medicare, his situation would not improve much: The union plan covers doctor’s visits and prescription drugs; without them, he could pay hundreds of dollars a month out of pocket. And his wife, who is a decade younger, would still need to buy insurance on the exchange.

“We have our house payment, we have homeowner’s insurance to pay, we have property taxes to pay, we have vehicle payments to pay,” Eubank said. “And we have living expenses like food, clothing, our heating bill. … Somewhere along the line, we can’t afford health care.”

Another former miner, 76-year-old John Wallace of Millstadt, Ill., worked for Peabody for 33 years and now estimates that losing his union health coverage will mean his prescription drug costs could go from $800 a year to more than $3,000 a year.

“It’s going to be rough on a lot of people, not just me,” said Wallace, who has chronic obstructive pulmonary disease and was treated for esophageal cancer.

There is legislation that has been sent to the Senate floor, the Miners Protection Act, that would address the pension shortfalls without increasing the federal budget deficit. The intervention is paid for largely through the imposition of slightly larger “merchandise processing fees” charged to importers starting in 2025. The Congressional Budget Office concluded this month that the higher fees would more than offset the costs of the bill.

McConnell, who has blamed Obama administration’s environmental policies for decimating the eastern coal industry, has indicated in recent months that he is willing to consider passing miner relief legislation but has stopped short of assuring its passage. He has not explained his hesitation, although some union officials suspect it could have something to do with the UMWA’s past support for his Democratic political rivals.

“We’ve got a lot of stuff that could be dealt with, but that’s certainly one of them,” McConnell said on Sept. 29 when asked about the Miners Protection Act and its prospects for the lame-duck agenda. McConnell spokesman Robert Steurer said last week that he had “no announcement on scheduling at this time.”

Said Smith of McConnell, “He’s really the key here, and everybody understands that.”

Last week, 22 senators led by West Virginia’s Joe Manchin III (D) and Shelley Moore Capito (R) signed a bipartisan letter calling on congressional leaders to pass the Miners Protection Act by year’s end. “This bill is simple — it is the continuation of a longstanding commitment by our government to lifetime health and retirement benefits for our miners,” they wrote.

As for Trump, he has not weighed in on the pending bill or the retirees’ plight. He had pledged to reverse Obama administration policies in a bid to restore coal jobs, but industry experts say the near-term decline in coal production has more to do with a glut of cheap natural gas than with federal environmental regulations such as the Clean Power Plan that aims to curb carbon dioxide emissions.

Eubank said he has faith in Trump: “I’ve never met him personally, but the state of West Virginia carried Mr. Trump in the election. We have no other choice, and I have total confidence he will take in and consider this.” But he is also in a bind: If he signs up for new health insurance in anticipation of losing his union coverage, and then Congress acts, he could lose upwards of hundreds of dollars in premiums.

“It sure would be nice if we could hear from the president-elect and his team about what they think about this,” Smith said. “We haven’t heard anything other than we want to help miners, and that’s good. We’re for that. … But if we’re going to solve the great level of issues that exist in America’s coalfield today, we’ve got to solve this pension and retiring health-care issue, along with all of the rest of it.”