California's health care reforms were on life support, and the pundits and the press were ready to pull the plug after a landmark measure failed in a Senate committee Jan. 28.

But the next day Gov. Arnold Schwarzenegger, R, and health care advocates declared their determination to breathe life back into their proposal to make insurance coverage and care more affordable and accessible for the state’s 6.7 million uninsured.

They just aren't sure how to revive their $14.9 billion plan.

"It's very clear this is a huge undertaking," Schwarzenegger said in a speech Jan. 29. "We knew this, and so this is why we've got to continue working on this. I have absolute confidence that eventually we will get it done."

The governor later joined Assembly Speaker Fabian Núñez, D, and more than two dozen representatives from labor, consumer, hospital and insurance groups at a press conference in Sacramento. They vowed to continue pushing for their ambitious plan to expand existing government-sponsored medical care for the poor and provide a new pool to purchase insurance for Californians without health coverage.

"We may have lost the first round in this fight, but there are still 11 more to go," Núñez said.

Many of the pundits said the Senate Health Committee's 7-1 vote had delivered a knock-out punch. But the governor and Núñez promised to continue to press for a comprehensive plan to require that all Californians have medical coverage and to subsidize premiums for those who can't afford them. Taxes on tobacco and hospitals would be raised to help pay for it, and most businesses would have to provide workers with medical insurance or pay a fee to the state.

AARP CEO Bill Novelli said AARP would also continue to fight for reform and to work with Schwarzenegger and legislative leaders "to break the gridlock and put their state on track for comprehensive health care reform."

California Senate President Pro Tem Don Perata, D, opposed the comprehensive health care proposal as too costly, now that the state faces a $14.5 billion deficit, and scoffed at plans to revive it. Instead, he proposed enacting pieces of the plan, including expanding the state's high-risk insurance pool to provide coverage to those with health problems.

Perata also called for adopting higher tobacco taxes and hospital fees. But he proposed using the new revenues to offset proposed health budget cuts rather than expand coverage.

"It's going to take a little time for the bruises to heal and to figure out what is doable this year," Casey Young, AARP California advocacy manager said. "There are a lot of hard feelings, but we keep going forward with what we can get done."

AARP had joined other consumer groups last year in seeking a cure for the state’s ailing health system. The governor had declared 2007 the "Year of Health Care Reform" and promised California would lead the way for the rest of the nation.

From the nation's capital to state capitals across the country, elected leaders watched California to see if he was right. Even the two leading Democratic presidential candidates—Hillary Clinton and Barack Obama—proposed plans similar to the one Schwarzenegger advanced.

Despite the national attention, divisiveness reigned. Budget battles, tax disputes and debates about the extent of the health care reforms roiled the California legislature.

Over the Republican governor’s objections, the Democratic-controlled Assembly and Senate finally approved a health care measure near the end of their 2007 session, but it fell short of Schwarzenegger's goals. He vetoed it.

The governor called the legislature back into special session and eventually struck a deal with the Assembly Democrats. They approved his bill in December.

But Perata, the Senate leader who had backed health care reform all year, in the end turned against it because the state's budget picture had soured. He warned the governor and the Assembly speaker that their health plan could "devastate a state budget already teetering on insolvency." The Senate Health Committee followed his lead and rejected the bill.

Its vote reverberated around the nation. It seemed California had only shown how difficult health care reform is, but advocates warned against that conclusion. They claimed California is unique. It's the nation's most populous state. It has a deeply divided legislature that requires, unlike most other states, a two-thirds majority to raise taxes, enabling the Republican minority party to block every funding plan. In addition, the state's deficit ballooned while lawmakers debated the bill.

"With apologies to New York, if we could have made it here, we could have made it anywhere," says Anthony Wright, Health Access California executive director. "But that doesn't prove the inverse. We have taken health care reform significantly far in a place with high hurdles. That builds a path for other states."