The roughly 25,000 retired coal miners that rely on federal support for their black lung treatments have enough to worry about without fretting that government leaders won’t maintain an excise tax that finances their treatment fund. And yet, the Black Lung Disability Trust Fund, which was established in 1978 and finances workers’ black lung disease claims through a tax on per-ton sales by coal mine operators, is in danger of drying up by 2020, according to the Associated Press.

Black lung, another term for pneumoconiosis, is a condition caused by inhaling coal dust and presents in symptoms such as coughing, inflammation, and fibrosis, a thickening and scarring of tissue. A 2018 report from the Centers for Disease Control and Prevention (CDC) found that at least one in 10 coal miners who had worked in the mines for at least a quarter-century had black lung and in Appalachia, that rate skyrocketed to one in five. That’s the highest-ever recorded level of the condition, and many cases are being diagnosed in younger workers, well under that 25-year threshold.

One reason the Fund is in danger of being depleted by the middle of 2020 is due to the 2018 government shutdown, which cut the necessary tax as of Jan. 1, and it has yet to be restored. Several senators representing states with major coal production interests are trying to shore up the Fund for another 10 years. The American Miners Act of 2019 includes a provision that would protect healthcare and pensions of those with black lung.

But support for coal workers will fall short unless the act is passed, and this is part of a distressing pattern. Under President Trump, the coal industry has continued to suffer and so have workers. In January, Fortune looked at how coal-fired power plant closures have surged during the Trump administration. And 2018 saw the highest number of plant closures since 2015.

One reason has to do with toxicity. More than 90% of American coal plants were found to contaminate nearby water, including groundwater, with chemicals including arsenic, chromium, and lithium. And in 2017, Environmental Protection Agency regulations that cut carbon dioxide emissions were cut. The EPA is currently run by Andrew Wheeler, a former coal industry lobbyist.

And if coal plants are causing that much environmental damage, it makes sense that workers would suffer from extreme symptoms and illnesses after working in the mines. Not being able to rely on federal support from the Black Lung Disability Trust Fund, whether for your own condition or the associated survivor benefits, seems like a particularly bleak prognosis.