WASHINGTON – 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.

Sen. Max Baucus (D-Mont.), the chairman of the Senate Finance Committee, seen here at the Center for American Progress Action Fund on March 27, 2009, led the effort to pass health care reform legislation. Center for American Progress Action Fund

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.”

JTA

Democratic members of Congress and Jewish organizations around the region lauded the health-care bill signed into law earlier this week, even as Republicans prepared to launch legal challenges.

After watching President Obama sign the legislation into law on Tuesday morning, Rep. Bill Pascrell (D-8), one of the bill’s sponsors, told this paper that the legislation is “a big step forward.”

“The benefits are just outstanding,” he said.

The bill, he said, guarantees that no one can be denied health coverage because of pre-existing conditions. He also cited tax credits to 116,000 families and 15,200 small businesses in his district.

The congressman summed up the bill in a single phrase: “Health security.”

“Those left out [of coverage] with preconditions will no longer be denied,” he said. “That’s a huge change.”

Pascrell lashed out at the bill’s critics who have repeatedly warned that the legislation would lead to health-care rationing or that those satisfied with their current coverage would be forced to abandon it.

“Existing plans are grandfathered under this bill,” he said. “I am tired of the lies and misrepresentations and prejudicial statements.”

Rep. Scott Garrett (R-5), a critic of the bill who was one of 212 to vote against it in Sunday’s House vote, did not return calls or e-mail requests for comment. A statement on his Website blasted the health bill.

“While I appreciate the efforts of the majority to reform our health-care system, it is hard to underestimate what a grave mistake it would be to enact this bill,” he said in the statement. “It would fundamentally alter our citizens’ relationship with their government. It would seriously jeopardize our nation’s long-term prosperity. It would dampen the vitality of our nation’s health-care innovators. It would restrict choice and access to medical care for millions of our nation’s elderly and poor. It would tax hundreds of billions of dollars out of the economy in the midst of one of the most serious economic downturns in our nation’s history. And for all this — for all of these thousands of pages and hundreds of new bureaus, boards, and bureaucracies — it won’t make America any healthier.”

Rep. Steve Rothman (D-9), one of 219 “yes” votes from the House, said in a statement sent to this paper, “This legislation will make a marked improvement in the lives of my constituents and will be a great step forward beyond the present system now causing so much cost, heartache, and tragedy to so many throughout my congressional district, New Jersey, and our entire country.”

The bill also earned praise from area Jewish organizations, including Jewish Family Services, which frequently serve clients without any insurance coverage.

“We work with a lot of people who have no insurance whatsoever,” said Lisa Fedder, executive director of JFS of Bergen and North Hudson in Teaneck. “The fact that more people will be able to be insured and get the services they need is a great opportunity.”

The bill will have a large impact on people who lost their jobs during the economic crisis and are still struggling to make ends meet, as well as those working for small businesses that had begun to stop paying for their employees’ health care, Fedder said.

“It’s not a perfect bill, but I think it’s a great beginning,” said Leah Kaufman, executive director of JFS of North Jersey in Wayne.

Kaufman has seen many clients who have no insurance and no steady income put off doctor’s visits to avoid racking up bills. This legislation, she said, would provide them with the coverage they need. She also praised the bill’s inclusion of children up to age 26 on their parents’ policies as helpful, since many recent college graduates are struggling to find work.

“There are so many people out there who can’t get medical care because they don’t have coverage and can now get that kind of care,” she said.

Rabbi Neal Borovitz, spiritual leader of Temple Avodat Shalom in River Edge and a member of the Jewish Community Relations Council of UJA Federation of Northern New Jersey, called the new legislation the best possible for now.

“I don’t think it answers all of the issues facing us, but it’s an improvement,” he said. “To me, we can’t aim for perfection. We have to always try to look for the best possible solution. This health-care bill is the best possible that could be achieved at this moment in time.”

Jacob Toporek, executive director of the New Jersey State Association of Jewish Federations, which represents in Trenton the Garden State’s 12 federations, praised the bill’s inclusion of the Community Living Assistance Services and Supports Act.

“From that perspective,” Toporek said, the bill is “a major plus for the Jewish community.”

The CLASS Act is a provision that would create a voluntary disability insurance program for adults with long-term needs and alleviate pressure on the Medicaid program. According to the legislation, eligible enrollees who need assistance performing common daily activities — such as dressing, bathing, and eating — would receive cash benefits to pay for support services in a community setting. The Jewish Federations of North America had lobbied for the act’s inclusion in the health bill.

“How better to practice tikkun olam than by providing these people who are in need with the ability to get mended?” Toporek said.

“Clearly it pleases all of us as professionals that more people will be covered under health-care coverage,” said Charles Berkowitz, executive vice president of The Jewish Home at Rockleigh. “There are people who will be able to get great coverage now that couldn’t before.”

For more about the bill see Groups pushed health reform, but some keeping quiet on bill.