The promise of lifetime health care was won in 1946, the product of a two-month strike by the United Mine Workers of America (UMWA) against the Bituminous Coal Operators Association (BCOA), in which the federal government took over the mines to negotiate a settlement with the union. The settlement created for the first time the UMWA Health and Retirement Funds.

Northeastern Pennsylvania miners, numbering 76,000 in 1946, conducted separate negotiations with the anthracite coal operators. When their contract expired on May 30, one day after the agreement was reached in soft coal, miners immediately walked off the job. After an eight-day strike an agreement was reached with the operators patterned after the BCOA agreement. No government takeover of the mines occurred in anthracite. The hard coal miners also won for the first time a health and welfare fund to be paid for by the companies through royalties per ton of coal mined. But anthracite miners never won the same government-backed guarantee of "cradle-to-grave" health care.

Pensions were set at $100 per month, the first pensioners receiving checks in 1948. By early 1949 more than 15,000 miners and their families had received benefits from the Anthracite Health and Welfare Fund--3,138 were retirees. Health care in the entire region underwent drastic improvement under the impact of the miners' victory. Outpatient clinics were opened up throughout the area to treat silicosis and other occupational diseases.

Depressed conditions in the industry brought a dramatic decline in production of anthracite coal from the late 1940s until the early 1990s. Today there are between 1,500 and 2,000 anthracite miners. Once a bastion of union organization, less than 25 percent of miners here are members of the United Mine Workers of America. Pensions for retirees top out at $90 per month and there is no provision for medical care for retired miners and their families. Wages for laborers in many of the nonunion mines in the region start at $7–8 per hour. Most coal is strip-mined, and many operations today reclaim coal from culm banks--refuse piles left over from old mining operations or bank mines. There are still several small underground mining operations of one to five people, mostly family owned.

Resistance to the operators' drive against wages, health, and safety continues today in the anthracite region. In 1998–99, UMWA miners struck against the Jeddo-Highland Coal Co., one of the four union mines in anthracite. The 13-month strike inspired solidarity from miners and other workers in the area as well as community residents who were protesting mine owner James Pagnotti's plan to fill a mined-out area with construction and demolition waste from seven surrounding counties. While strikers did not win all of their demands, which included improved health care and pensions, they did achieve wage parity with the other union mines in the region.

Thousands of retirees today live with inadequate pensions and health care. It will take renewed struggle in the anthracite mining communities and linking up with the developing social movement in the bituminous coalfields to win the right to a secure retirement for these workers who built the union.  
 
 
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