Power from coal-fired thermal power plants (TPPs) represents a large percentage of the electricity generated in India. As the demand increases, expansion of the coal-fired TPPs is the most likely scenario, which will lead to an array of environmental and health impacts. The proposed projects in India net a generation capacity of 300 GW through 2030. With limited emission control regulations in place, this will increase the number of health impacts—some from direct particulate matter (PM) emissions and some from secondary PM, especially due to the chemical transformation of sulfur emissions. The WRF-CAMx chemical transport modeling system was utilized to study the impact of these emissions from the planned coal-fired TPPs. The additional 300 GW of projects will result in 3-times the coal consumption and at least 2-times the health impacts (premature mortality and asthma attacks), compared to those estimated for the operational TPPs. The technology to control all criteria pollutant emissions, which could reduce the health impacts linked to ambient PM2.5 from the coal-fired TPPs by as much as 50%, is widely available, and the only barrier to implementing these solutions is the lack of a stricter timeline.