The U.S. Congressional Republicans’ repeal-and-replace bill that throws out core provisions of the federal Affordable Care Act preserves special provisions for Libby asbestos victims, Sen. Steve Daines’ office said Tuesday.

Daines, R-Montana, talked with key Republicans over the weekend about the need to retain Libby-specific health care provisions as Congressional leaders prepared for the roll-out of the draft bill on Monday. He followed up with a letter to Speaker of the House Paul Ryan and Senate Majority Leader Mitch McConnell, pointing out that toxic exposure from decades of vermiculite mining in Libby “remains an environmental and public health crisis.”

A spokesperson for Daines’ office said it’s unlikely the Libby provisions will be touched as the Republicans shape their version of the health care bill. Daines has been critical of the federal law, calling it a “disastrous” law in his letter to Ryan and McConnell and noting it “has caused severe hardships on countless Montanans.”

Dr. Brad Black, medical director of the Center for Asbestos Related Disease, or CARD Clinic in Libby, said he is pleased Daines is going the distance to preserve the special health care provisions for Libby.

“It’s remarkable Senator Daines took this initiative to stand up and help protect [asbestos victims],” Black said. “He realizes how valuable this is to the community. It serves as a kind of social justice to those who were so unfairly treated.

“Senator Daines is in a politically important position to have an effect on this,” Black said. “This piece (the Libby provisions) is so valuable to the community in healing.”

IT WAS former Sen. Max Baucus, D-Montana, who was instrumental in getting special provisions for Libby asbestos victims in the landmark Affordable Healthcare Act.

Those provisions — put in effect in 2011 — provided money for an ongoing screening program at the CARD clinic. Since 2011, 4,500 new individuals have been screened for asbestos disease at the clinic, according to CARD Administrative Director Tanis Hernandez. Of those screened, 2,025 were diagnosed with asbestos-related disease.

Since the extent of the toxic asbestos poisoning from the former W.R. Grace & Co. vermiculite mine came to light in late 1999, about 7,000 people have been screened, and about 3,200 have asbestos-related disease, Hernandez said.

“We still continue to see 200 to 250 new patients every quarter; close to 700 to 800 people per year,” she added.

A second prong of the Libby provision makes those diagnosed with asbestos-related disease in Libby — regardless of age — eligible for Medicare under the Affordable Care Act. Hernandez said Daines’ letter to Congressional leaders incorrectly stated that the provisions provide access to Medicare for anyone exposed to asbestos. The patient must be diagnosed with asbestos disease to get access to Medicare, she explained.

The Medicare provision for Libby asbestos victims is most important for those younger than 65, Hernandez noted. Since 2011, 1,846 people under 65 have accessed Medicare through this part of the Affordable Care Act’s Libby provisions.

A third provision in the existing federal health care law created a pilot program that provides medical care, home care and daily living assistance not covered by Medicare. About 1,300 patients are using that program.

LIBBY CONTINUES to deal with the aftermath of widespread death and disease prompted by toxic asbestos exposure from the vermiculite mine near Libby. More than 400 deaths have been linked to asbestos disease.

After treating asbestos patients for so many years, Black said the staff now has a better idea of how the various exposures from the mine have affected people.

“I don’t know that we would have anticipated cases coming at this rate,” he said. “It doesn’t appear to take ... much of these fibers to cause lung disease. Exposures after the mine closed (in 1990) are showing up with lung disease.

“We’re having a steady flow of people coming for screening that are still getting ill; it’s significant, it’s not just a few,” Black said. “Clearly it’s something needed for the longer term. Who knows if that is 10 or 20 years.”

Features editor Lynnette Hintze may be reached at 758-4421 or by email at lhintze@dailyinterlake.com.