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Several Bay Area Jewish groups involved in health care and working with elderly populations are concerned about the local impacts of AHCA, the American Health Care Act passed yesterday by the House of Representatives. The bill would repeal and replace major parts of the Affordable Care Act — aka Obamacare.

Major provisions of the bill include an $880 billion cut to Medicaid over 10 years, ending it as an open-ended entitlement, cut taxes of high-income people by nearly $300 billion, and allow insurers to charge older adults five times as much as they charge young adults for the same coverage.

All 20 California Republicans in the House voted in favor of the bill.

“We believe this is going to have a catastrophic effect on our clients,” said Donna Waldman, executive director of the Jewish Community Free Clinic in Santa Rosa. “It’s hard to say exactly, but probably more than 25,000 people in Sonoma County alone will lose their coverage.”

Waldman noted that after passage of the Affordable Care Act, annual clinic visits dropped to 1,800 a year, from 3,500 a year.

Now, Waldman is looking at ways to add additional doctors in the clinic.  “If the Republican bill becomes law, we expect it to be worse than 3,500 encounters a year,” she said.

Jewish organizations that help older adults are particularly concerned. People over 65 may face dire choices, said Rita Clancy, director of adult services at Jewish Family and Community Services, East Bay. “They may have to choose: Do I buy medicine, or food? Older people are going to go hungry.”

Over a given year, JFCS East Bay helps somewhere between 400 and 500 older adults, Clancy said. Another client group — adults between 50 and 64 — could also be gravely affected, as they are not yet eligible for Medicare and may see great increases in their insurance premiums.

“There are people who don’t fall anywhere, those that are less than 65 but over 50,” she said.

The AHCA would let insurers charge older Americans more than five times what they charge younger adults. It is currently capped at three times.

Now the bill is headed to the Senate, where a handful of Republican senators have rejected it, and signaled they would begin work on a new version, largely from scratch.