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The government might shut down because Congress is fighting over health care for retired coal miners (again).

U.S. lawmakers are scrambling to put together a long-term spending bill before the April 28 deadline, and a few “hurdles” stand in the way, according to The Hill. Besides the usual flashpoints, like Obamacare and immigration, there’s also the question of whether to give permanent pensions and health care for tens of thousands of retired miners, many of whom suffer from black lung and lasting physical injuries from years on the job.

This debate has been ongoing since last year. In December, with Democrats threatening a shutdown, Republicans eventually agreed to fund miners’ benefits—but only temporarily, which is why this fight is happening again this year. Generally, coal companies themselves would provide these. But as the U.S. has moved toward less carbon-intensive energy sources, many of those companies have gone bankrupt and the financial responsibility for those plans has shifted to taxpayers.

As the New York Times detailed in a heartbreaking piece this week, more than 20,000 retired miners will lose their health benefits if Congress does not intervene—and those miners are scared senseless about what will happen to them if their benefits expire. They’re also wondering why President Donald Trump, with all his campaign talk about how he’d “take care” of miners, hasn’t said a word about their benefits. “He promised to help miners, not just mining companies,” one retiree said.