Coal electricity generating units historically contributed to air pollution and its associated health burden in the United States. The true health burden is unknown, however, because of limited evidence on the health response related specifically to coal pollution. We estimate exposure to fine particulate matter (PM2.5) associated with power plant sulfur dioxide (SO2) emissions from 1,237 US coal power plant units. Exposure is estimated using the HyADS model, which combines information from the HYSPLIT air dispersion and transport model with output from a full-scale chemical transport model to estimate annual coal PM2.5 source impacts from each coal power plant. We link this exposure to the Medicare dataset and find that coal-specific PM2.5 exposure is associated with a greater risk of mortality than PM2.5 from all emissions sources. From 1999-2020, average national coal PM2.5 reduced by about 90%, with consistently higher concentrations in the eastern half of the country. We estimate 460,000 deaths that are attributable to SO2 emissions from US coal power plants. Before 2007, premature deaths averaged over 43,000 per year. After 2007, annual deaths decreased substantially as many facilities installed emissions controls and/or reduced operations. In 2020, we attribute 1,600 mortalities to coal pollution.