HEALTH CARE DECISION — Jews react: Jewish Family Service CEO

Jewish Family Service of Los Angeles CEO Paul Castro lauded the announcement of the Supreme Court’s decision this morning to uphold President Obama’s Affordable Care Act, saying it will benefit JFS’s target population.

“For our clients, who are on the poorer end, we’re hoping that there is going to be greater accessibility to health coverage,” Castro said.  “We see many clients who have no coverage, and they come to us because they need help trying to get coverage.”

In fact, some of the law’s provisions already are in place in California, he said. “California has already been ahead of the game in terms of state opportunities for coverage, through programs for children and others, and our hope is this will allow it to expand beyond children, to adults who don’t have access to health insurance.”

JFS is already part of the process of moving forward on initiatives spawned by Obama’s health care act, Castro said. The act includes funding for innovations in streamlining care, a process California has already begun.

“With the support of the Federal government, the state has been moving folks out of siloed programs into a more integrated system through Medi-Cal managed care,” Castro said. JFS can help in figuring out how to make that transition in a way that does not outstrip the levels of Federal reimbursement, and has already been working with the managed care plans in Los Angeles County charged with making the transition.

“These are high utilizers of medical care, and if not appropriately managed in the transition to a new system, it can be a large cost item. Not only does JFS know the business, but we know these clients and we know what keeps them out of higher levels of care,” Castro said.

But, he added, “Our major concern is that, in the effort to get streamlined and integrated, our most frail and vulnerable clients are not the casualty of an attempt at efficiency.”

Given that Federal funding and state programs are intricately linked, Castro said he worries about the permanence of the state budget Governor Brown signed this weekPu. JFS programs that serve vulnerable populations –people who are poor, elderly, abused, mentally ill and disabled – were left intact in this budget. But, the new budget relies on voters passing a tax increase in the November elections – an initiative JFS supports.

“If that initiative doesn’t pass, there is immediately an additional hole in the budget, in which case I would suspect the governor would then put the legislature into emergency session and there will be large cuts across the board,” Castro said.

At the same time, he is not fully rejoicing over the Supreme Court’s decision.

“I can already see the opposition lining up with talking points about it being a tax, so I can see how energy is going to coalesce around opposition and an effort in congress to if not repeal it, minimize things that they see as onerous.”

Still, he believes the court’s decision keeps the topic on the table.

“I’m happy the decision was upheld because it keep the whole conversation about having affordable heath care open. We can debate about whether it’s enough, or if it’s too much, but the court has said ‘we’re out of it now,’ and this is your conversation.”