Gov. Arnold Schwarzenegger proposes sweeping changes that will extend health coverage to nearly all of California's 6.5 million uninsured. The plan contains some elements that will likely provoke huge opposition from the health care industry.
But the plan is not a state-funded program. Instead, Schwarzenegger wants to spread the burden to doctors, hospitals, insurance companies and employers. Every Californian, including those in the country illegally, would be required to have health insurance.
Those who can't afford it would be subsidized.
The governor's health plan is one of the most extensive overhauls since the failed effort undertaken by President Clinton more than a decade ago.
The California proposal comes in the wake of a similar plan passed last year in Massachusetts. Together, they signal a new activism on health care on the part of the states, which have shown impatience as the federal government avoids taking on the issue.
Like the system in Massachusetts, Gov. Schwarzenegger's plan revolves around an "individual mandate" — which means citizens have to buy their own insurance. But the changes are meant to make it easier for people to do that, by changing insurance rules and offering subsidies.
The California plan also includes elements intended to appeal to both liberals and conservatives. For liberals, there are expanded benefits, particularly for low-income children; for conservatives, there are new accounts that will reward people who practice healthy behaviors, in addition to added tax incentives.