Coal-fired power plant regulatory rollback in the United States: Implications for local and regional public health

President Trump wants to promote coal and weaken Clean Air Act regulations that affect coal-fired power plants. We analyze which US regions have benefited from air quality improvements realized since adoption of two Clean Air Act power plant rules, the transport and mercury rules, which have been targeted by lobbyists and national officials. For 20 coal states, we create a pre-regulatory emissions scenario for the current (2016) fleet of power plants. Using the US Environmental Protection Agency's CO-Benefits Risk Assessment screening model, we estimate the differences between the impacts of pre-regulatory emissions and current emissions on fine particulate matter (PM2.5) concentrations and on public health. We compare those impacts with voting patterns in the 2016 presidential election and with demographic data. Among the air quality and public health gains of the current situation relative to the pre-regulatory scenario are that: annual average PM2.5 concentrations are lower by 1–5 μg/m3; 17,176–39,291 premature mortalities are avoided for each year of lower emissions; coal mining counties and White, rural counties experience some of the best improvements in air quality; and, in several states, Trump counties benefit more than Clinton counties. We suggest refining these results with atmospheric dispersion models.