Perspective from the 19^th Hole 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 to 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 my professional positions, including as press secretary in Washington, D.C. for a Democrat Congressman from Oregon (Les AuCoin), as an Oregon state government manager in Salem and Portland, as press secretary for Oregon’s last Republican governor (Vic Atiyeh), and as 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.  I could have called this blog “Middle Ground,” for that is what I long for in both politics and golf.  The middle ground is often where the best public policy decisions lie.  And it is where you want to be on a golf course.

The stories I mention in this blog headline came with these headlines:

• Experts deliver options to plug $421 million gap in Medicaid funding

• Oregon Health Authority director resigns

As for my memories:  I represented major health care organizations as a lobbyist at the State Capitol in Oregon for about 25 years and these stories, published in July 2026, could have occurred many times in previous years.

Because, health care is a controversial topic anywhere, including in Oregon.

It’s tough to provide enough money to fund growing low-income health care needs, plus it is tough to keep leaders at the top of a health care management pyramid.

Before a few further comments from me, here is more information on both stories:

Million Medicaid Gap:  In a presentation to the Oregon Health Policy Board , the Governor’s Advisory Group on Medicaid Sustainability reviewed a report with 40 options to find savings in the Oregon Health Plan to close a $421 million gap in the 2027-29 budget cycle.

Key recommendations are to find administrative efficiencies before cutting benefits, maintain dental coverage instead of cutting it, and reduce covered services based on clinical evidence.

Governor Tina Kotek tasked the group, led by former Oregon Health Authority leader Bruce Goldberg and the Governor’s health policy advisor Kristina Narayan, with finding ways to keep Oregonians insured and maintain meaningful benefits despite major cuts from the federal government.  HR 1, the so-called Big Beautiful Bill, will result in an estimated $9.4 billion loss in federal Medicaid funds by 2031.  Kotek will make final proposals for Medicaid savings in her Recommended Budget, due to the Legislature on December 1.

Oregon Health Authority Director Resigns:  Early this month, Kotek accepted the resignation of Oregon Health Authority Director Dr. Sejal Hathi.  She then appointed former director of the State Department of Human Resources, Fariborz Pakseresht, to serve as Interim Director, effective July 6.

Back to my thoughts.

First, I fought for years for more money for Medicaid, the program that tries to meet the needs of low-income citizens, including in Oregon.

But Medicaid competes for funding against such stalwarts as K-12 education and public safety.  So, it always a battle and, of course, it’s made worse these days because Donald Trump wants to cut all programs other than those from which he benefits.

As for the Oregon Health Authority director, she came to Oregon a couple years ago with high marks from her tenure in health programs in Washington, D.C.  But she didn’t last long.

In a bit of twist, the guy who is helping Governor Kotek find ways to cut Medicaid (the first story) is Dr. Bruce Goldberg, a former Health Authority director himself.  So he illustrates that former directors can find a new professional life.

Enough from my past health care past.