As the clock ticks toward the full implementation of the Affordable Care Act next year, Jewish federations, the largest Jewish stakeholders on the issue, are mobilizing their members to ensure that the historic health care reform does not hurt funding for communal health care institutions.
Depending on how it is implemented, the legislation, Jewish leaders fear, could have a direct impact on more than $7.5 billion that federation agencies receive annually in Medicaid and Medicare funds to provide health care services to Jews and non-Jews.
“We are working with policy leaders to ensure that the law is upheld fairly and to send a clear message that laws have an impact on real people and real institutions,” said William Daroff, vice president for public policy at the Jewish Federations of North America, a federation umbrella organization. “If a Jewish nursing home receives less money per bed, it is clear that it will not turn down the person in need, but the nursing home will have to come to the federation and to donors to cover the difference.”
In a recent conference on health care reform, federation officials urged their members to speak to lawmakers and to lobby administration officials in a last-ditch attempt to influence the regulations that will give concrete shape to the landmark law passed in 2010.
Care for the elderly is a prime concern for the Jewish community, which is aging significantly faster than the general population. Currently, 20% of American Jews are 65 or older, compared with 13% of the general population. The Affordable Care Act, commonly referred to as Obamacare, would have a direct impact on some of that funding, mainly because the structure of government funding and reimbursement is about to change dramatically.
In Chicago, for example, 19,000 older adults receive services from CJE SeniorLife, the Chicago federation’s network of elderly care services, at a total cost of $50 million a year. Most of the expenses are covered by federal programs or by recipients of the services, with 10% being paid for by allocations from the federation. Even the slightest drop in government funding would translate immediately into a need for more federation dollars to go into the community’s elderly care system.
A cut in funding could result from the transformation of health care reimbursement from a fee-for-service system into a result-based model under the new law. Jewish communal officials are also focused on the impact of incentives that the new law offers to health care providers who forge partnerships to improve their quality of care.
Hospitals, for example, would be rewarded for a low readmittance level, a decision that led Chicago’s Jewish network of senior care services to partner with three hospitals to work together on lowering readmission rates. “This will allow us to fulfill our mission in this new paradigm and to see how we can become part of the solution,” said Bruce Lederman, board chairman of CJE SeniorLife. Lederman argued that the new funding system provides federations with opportunities rather than concerns.