How Politicized is Public Healthcare in Orange County?

Questions are growing over just how politicized the board of Orange County’s healthcare plan for the poor is amid a face-off between a state assemblyman and county supervisors on if they should get to continue exerting control over the public health plan. 

It comes after Assemblyman Avelino Valencia (D-Anaheim) rewrote a bill this week to remove county supervisors from the board and take away the power to appoint the rest of the board members.

[Read: Could OC Supervisors Lose Control of County’s Health Plan for the Poor?]

To read the full text of the bill, click here.

But Supervisor Vicente Sarmiento and Supervisor Janet Nguyen, who both currently sit on CalOptima’s board, told a different story during an emergency meeting on Thursday afternoon when board members denounced the bill. 

Sarmiento claimed the entire bill was retaliation for the county legislative office not returning a call to Valencia.

“You don’t want to dismember a board just because somebody doesn’t return your phone call,” Sarmiento said in an interview after the meeting. “We’ll leave it with that.” 

According to Sarmiento, the phone call was to clarify whether supervisors supported letting the alternate member for CalOptima’s board read confidential legal documents after a dispute last year when Nguyen, who at the time was the alternate, complained she could not review the results of an investigation. 

[Read: Does OC’s Healthplan for the Poor Really Know What It’s Spending On?]

While CalOptima’s board previously voted against allowing alternates to review the documents, Nguyen voted in favor. 

In a statement to Voice of OC on Thursday afternoon, Valencia defended his actions, saying it was in response to the board’s division on the issue and highlighting other political actions in recent years. 

“Our office received a bill the County agreed to support unanimously. When AB 2194 came with divided support by each of the respective Supervisors that serve on the CalOptima board, we asked for clarification, which is what any office would do when unanimous support changes,” Valencia wrote. “That’s not a personal dispute, it’s due diligence.” 

“To move forward with the proposed CalOptima amendments, our office had asked that a majority of the Board reach consensus on whether they want to proceed,” Valencia continued. 

Former Assemblyman Tom Daly, CalOptima’s lobbyist and Valencia’s former boss, backed that up in his comments to the board during public comment on Thursday afternoon. 

“He feels like there’s too much politics in the operation,” Daly said. “I heard that from his lips.” 

Valencia’s bill comes after multiple investigations into former Supervisor Andrew Do, who eventually pleaded guilty to bribery charges after serving on CalOptima’s board, and investigations into Nguyen when she served on the board over a decade ago. 

[Read: OC Grand Jury Issues Scathing Report on CalOptima]

Do was not charged with anything in connection with CalOptima, but resigned from the board after he was fined $12,000 for trying to steer public contracts to campaign donors. 

[Read: Orange County Supervisor Andrew Do Faces $12,000 State Fine Over ‘Pay to Play’ Politics]  

Nguyen also faced questions at the time from her fellow supervisors and former CalOptima board members about her control of the agency. 

[Read: Nguyen Harshly Criticized by Colleagues Over CalOptima Audit]

“This is just one example, in addition to recent politically charged actions led by the OC Board of Supervisors board members that has resulted in a misuse of public healthcare resources. Especially after the well-documented, politically charged issues that have surrounded this board in recent years,” Valencia wrote in Thursday statement to Voice of OC.

Valencia’s bill is up for a hearing on the state Senate Committee on Health next Wednesday. 

During Thursday’s emergency meeting, multiple CalOptima board members questioned if it even was possible to remove politics from the agency, pointing out that under Valencia’s bill, the board members would still be chosen by a group of state and federal elected officials.  

Maura Byron, the current vice chair of CalOptima, said that while she didn’t agree with Valencia’s idea, she said the board may need more insulation from politics. 

“Part of me says I think CalOptima should be insulated from day to day political pressure and I think this is really evident right now,” Byron said during Thursday’s meeting. “The people who really need to be here to make decisions are healthcare professionals, people who have skin in the game.” 

Sarmiento also said the board’s makeup is inherently political. 

“Well it’s impossible to pull politics out of any board. I don’t think CalOptima is unique,” Sarmiento said in an interview. “Appointees can be easily influenced by others that make those appointments.” 

Currently, the board members for CalOptima are appointed by county supervisors. 

Ed Kacic, a former chair of CalOptima who was pushed out after Nguyen joined the board in 2012, said he supported Valencia’s idea to remove county supervisors, pointing out that their power over the agency often hamstrung it and forced the health insurance plan to cater to politics. 

“I think the idea is good, I don’t think the supervisors should be on the board,” Kacic said in a Thursday interview. “I think the board ought to be as independent as possible knowing they have a lot of responsibility and the supervisors have the ultimate responsibility.” 

“I think the health plan has maybe outlived its need.”

Noah Biesiada is a Voice of OC reporter. Contact him at nbiesiada@voiceofoc.org.

Related