Repair the world? Jewish groups would be happy just to fix health care legislation.
For months, Jewish groups have been at the forefront of lobbying the U.S. Senate and House of Representatives for health care reform, framing their support within the Talmudic mandate of Tikkun Olam, repairing the world. The National Jewish Democratic Council even earned a special thank you from Sen. Max Baucus (D-Mont.) when the bill finally passed the Senate on Dec. 24.
Now that the House and Senate versions of the legislation are on the verge of converging into a single bill acceptable to both houses of Congress, the Jewish groups that focus on health care lobbying have correspondingly sent out the usual statements praising its advance.
Each of these statements, however, is peppered with a plethora of qualifications – most having to do with the absence of an option for government-run health plans that would compete with the private sector, although there are other aspects that irk Jewish groups, including language on abortions and pricing for seniors.
The statement from the Reform movement’s Religion Action Center was typical of the Jewish responses.
“The time is long past due to repair our broken system that leaves over 47 million people uninsured and millions more underinsured each year,” it begins. “We commend our nation’s senators who have been working tirelessly to bring us to this historic moment.”
Then comes the “while”: “While we are pleased to see a commitment to increased access to health insurance, we remain disappointed with key pieces of the legislation. The bill lacks a government-run public insurance option, which would control costs to further improve affordability and accessibility of care. We are also concerned about severe limitations to women’s access to reproductive health services.”
Rachel Goldberg, the director of aging policy for B’nai B’rith International, said health care reform advocates hoped to salvage some elements of the public option in the final version of the bill, once it emerges from a conference of the House of Representatives and the Senate.
“The important thing is to make sure there’s a mechanism to ensure competition,” she said, even if such an option is not government run; one possibility is the creation of nonprofit cooperatives. Health care reform advocates want a public option to crack insurance monopolies and duopolies that prevail in many states.
Like many other health care reform advocates, the Jewish Federations of North America, the umbrella body for federations, focused on urging Congress to preserve the Community Living Assistance Services and Supports Act, a voluntary insurance buy-in that covers long-term care for the elderly and disabled; both Senate and House bills include versions of the CLASS Act.
“This is the largest step forward in long-term care reform since the creation of the Medicare and Medicaid program nearly 45 years ago,” said William Daroff, the federation umbrella’s Washington director. “We believe the CLASS Act would create a fiscally responsible program that will strengthen our ability to deliver vital services to those most in need of them in our community.”
Critics contend that the proposed insurance plan is not self-sustainable and will require massive taxpayer funding.
“The real danger comes after 10 years, when the long-term care program will increase deficits and create even greater pressure for government rationing of medical care,” Scott Harrington, a professor of health care management at the Wharton School, wrote recently in The Wall Street Journal.
Jewish groups, representing one of the most rapidly aging demographics in the United States, also want to see aging removed as an insurance pricing factor, just as the legislation does with pre-existing conditions. They also want to remove the “doughnut hole” from Medicare, the government-run insurance program for Americans over 65. Currently, medicines are subsidized up until $3,000; recipients must then cover a “hole” of about $3,600 until they are again eligible for government subsidies.
For some groups, a critical issue is abortion. Both versions of the bill would introduce bureaucratic restrictions that abortion rights advocates believe eventually could end any government funding for insurers who provide abortions. The House version bans insurers from paying for abortions for clients eligible for any public funding; the Senate bill introduces a process for paying for abortion insurance that critics say is cumbersome and could lead to insurers simply not offering the coverage.
“On the one hand this should be a great moment,” said Sammie Moshenberg, the Washington director for the National Council of Jewish Women. “On the other, the extension of coverage to many people comes on the back of women’s access to reproductive rights.”
The intense, heated and often personal nature of the debate did not leave the Jewish community unscathed.
Sen. Joe Lieberman (I-Conn.), who had backed versions of the public option in the past, withdrew his support recently, saying he no longer believed the government could afford them.
That led to at least two petitions from American Jews urging Lieberman, the best-known Orthodox Jewish lawmaker, not to turn his back on the helpless.
“In our eyes, this is not the behavior of an ‘observant’ Jew,” said one petition, organized by Philadelphia’s Shalom Center and signed by 2,000 people, including 126 Jewish clergy. “’Tzedek tzedek tirdof, justice justice shall you seek,’ is among the Torah’s most important commandments. And in pursuit of justice, no autonomous Jewish community has ever allowed the poor to go without healing.”
That in turn led to a blast from Agudath Israel of America, which said that impugning belief was out of place in the public square.
“People should not appropriate the mantle of Judaism to promote their own personal or political convictions,” said Rabbi David Zweibel, the executive vice president of the organization, which is fervently Orthodox. “The Torah has much to say about caring for the sick. But turning it into a tool to promote a particular provision of a health care plan – or into a bat with which to pummel an outstanding public servant who happens to think that provision is objectionable – dishonors the Torah.”