US President Donald Trump (L) and White House senior advisor Jared Kushner take part in a bilateral meeting with Italy's Prime Minister Paolo Gentiloni (not seen) in Villa Taverna, the US ambassador's residence, in Rome on May 24, 2017. Photo by Mandel Ngan/AFP/Getty Images

Trump’s ACA Order Creates Health-Care Chaos


So now we face yet another assault on the health and safety of our nation due to the barrage of efforts by the current administration to dismantle certain provisions in the Affordable Care Act (ACA). This creates great risk and chaos within a system that is aimed at providing both proactive and reactive care to individuals in our country.

As a Jewish community, we should be outraged at the callous attempt to shirk society’s obligation to care for one another, both in terms of last week’s decision to cut subsidy payments to insurers (“cost-sharing reduction payments”) and the ruling to withhold the ACA’s promise of no-cost contraceptive coverage. As conversations and negotiations change by the hour, we are both encouraged to learn of bipartisan cooperation to save the cost-sharing reduction payments while at the same time disappointed with the administration’s insensitive statements and recommendations to eliminate someone’s health care.

This supersedes all other commandments, as it is inferred from one of the most well-known rabbinic teachings, the concept of pikuach nefesh, saving a soul, found in Mishnah Yoma. The text suggests that saving the life of yourself or another is so great that one is permitted to break the laws of Shabbat for the safety of human life. We must interpret this to modern day and protect the lives of millions who will be affected by attempts to cripple the Affordable Care Act. To dismantle a life-saving system is antithetical to the concept of pikuach nefesh.

Furthermore, the book of Leviticus (19:16) teaches that one should not stand idly by the blood of their neighbor. Many among us acknowledge the ACA is not a perfect system and does not go far enough to provide adequate health care to our entire society. Yet, to make provisions that seek to strip health care from any individual is to create a situation in which we as a society will be standing by the blood of our neighbor.

Although negotiations are ongoing, last week’s initial decision by the Trump administration to sign an executive order sends a signal to the insurance companies that their participation in the ACA is not cost-effective for their company. As insurance companies cease their participation in the ACA, it places many people in our society at great risk of losing their health care, putting their lives and the lives of their loved ones at risk.   

The Jewish community must look at the current health care debate and ask ourselves: Is the Trump administration seeking to save lives, or, by suggesting that we eliminate the cost-sharing reduction payments, are its actions creating a risky environment that will harm lives?

The answer is clear. We as Jews have a responsibility to care for one another. If the future health care of an individual is unknown, then we are ignoring our commandment of pikuach nefesh, to save lives.

It is the responsibility of us all to ensure the health and safety of one another.

The administration is taking a further step by issuing rules that would allow employers and insurers to withhold the ACA’s promise of no-cost contraceptive coverage. This is a direct attack on women, who should be the only decision makers for their bodies. Many have celebrated this recent ruling as a win for religious freedom but many organizations have a contrary view.

Any government-backed initiative that allows for discrimination based on religious belief is an affront to our religious freedoms. A provision in Trump’s order puts women’s reproductive health decisions in the hands of their employers and insurers. Our country has a long legacy of religious freedom, and recent attempts to incorporate discrimination into the legislative process based on religious freedom are antithetical to the core beliefs of our religion and the core beliefs of this nation.

We have a strong and healthy tradition of debate and dissent within the Jewish framework, but it seems clear that the dismantling of the ACA creates a dangerous situation in which the health care of many in our society will be in the balance. We must go beyond offering a misheberach for those in need of healing. The ACA and other initiatives that seek to provide sustainable and reliable health care to all link our prayers to our actions as we seek to truly heal those in need. 


Rabbi Joel Simonds is the founding executive director of the Jewish Center for Justice.

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