PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

This story caught my attention in a recent Wall Street Journal.

Under the headline, Health-Law Suit May Boost Insurers, Stephanie Armour wrote this:

“Health insurers and the Trump Administration face a court decision shortly that will determine whether the government must pay insurers billions of dollars despite Republican efforts to block payments they view as an industry bailout.

“Insurers have filed roughly two dozen lawsuits claiming the federal government reneged on promises it made to pay them under the Affordable Care Act.

“…Most of the lawsuits come down to a simple argument: Insurers say they were promised funding by the Obama Administration under the ACA, but Republicans opposed to the law blocked the payments. That money, they say, is still owed to them because they suffered financial losses.”

Why does this story get my attention? The key word is “renege.” Deals with the government don’t hold for any period of time. Government almost always reneges on the deals. Sound too negative? Perhaps, but that, frankly, has been my experience.

For me, this started back 2003 when hospitals and insurers in Oregon cut a deal with state government to accept new state taxes in order for the state to be able to use the “new state money” as match for federal Medicaid dollars.

[In the spirit of full disclosure, I was a state lobbyist representing both hospitals and insurers that were part of Providence Health System, one of CFM’s long-standing clients, which my colleagues still represent today.]

The idea for the new taxes sounded questionable, but was based on explicit U.S. government permission, as follows:  Impose a special tax on 16 major Oregon hospitals, take the money into the hands of state government, then use it to garner federal matching funds under Medicaid, the joint state-federal health care program for low income citizens. Also, impose a tax on commercial insurance payments and use the Medicaid money to fund new health coverage for children.

It turned out that the transactions illustrated that it is impossible to negotiate a deal with the legislature, then expect that deal to hold, even for one two-year budget cycle.

Something always intrudes.

Legislators and the governor forget the deal they cut, so they don’t honor it.  Or, a new “emergency,” real or imagined, comes up and the deal is off.  Or, even more perversely, legislators appear to honor the deal and devote the “new money” to health care, then, in a back room and out of public view, they take “general funds” out from behind the deal and allocate it elsewhere, including to the legislature’s top political priority — K-12 education.

Hospitals and insurers have operated in good faith in this transaction, but have suffered because of the realities outlined above, which underline again the inescapable conclusion:  You can’t negotiate and cut a deal with the legislature and expect it to be honored for any logical period of time.

Along the way, hospital and insurance lobbyists even have insisted on “memoranda of understanding” (MOU) to commemorate the deals over the years and, while not ironclad, the MOUs provided a bit of assurance that the legislators and the governor who signed them would live up to the deals.

No.  There was only one legislator who was at the table during the negotiations who admitted in public that legislators did not live up to what they signed.  That was Senator Betsy Johnson, the Democrat from Scappoose, who is one of the legislature’s chief budget experts, not to mention a public official whose style is marked by candor and integrity.

To her chagrin, she announced that legislators and the governor had reneged on the deal. Her position was that legislators should honor it.

It is not clear how long this house of cards will be allowed to stand, either for hospital or insurance taxes.

At some point, observers expect the federal government to say, whoa, we are spending a lot of money on this, given that the 49 states and D.C. now impose provider and insurance taxes.  We’ve got to stop, they may say.

When the federal government does say no, the question remains — what will states like Oregon do to replace the lost money?  The betting in this corner is that they will leave the hospital and insurance taxes in place, without the federal match.

Once new taxes are on the books, they stay on the books, even if the rationale goes away.

So, for me, the national insurance suit, as well as the situation in Oregon, illustrate the difficulty of cutting deals with government.