This paper makes two key points. First, coal production is no longer a reliable source of revenue to fund the Black Lung Program. Second, the problem is going to get worse fast, and policymakers should promptly prepare for that and ensure that coal workers are not left behind. As the coal industry breathes its last, policymakers can do right by mineworkers in many ways. Certainly one is to ensure that those left sick and dying are properly supported. Section 2 of this paper examines recent trends and projections for the Black Lung Program under current and alternative climate policies. Section 3 explores options for shoring up federal black lung benefits and otherwise improving the program.