After Gov. Arnold Schwarzenegger debuted his health reform proposal, several state legislators offered their own political solutions to expanding access to healthcare in California.

The most prominent proposals were presented by Assembly Speaker Fabian Nunez (D-Los Angeles), Senate President Pro Tem Don Perata (D-Oakland), Sen. Shelia Kuehl (D-Santa Monica) and a group of Senate Republicans. Additional proposals are also expected as the reform debate heats up.

California Medical Association government relations experts have compared the contents of each proposal. Here is a snapshot:

Assembly Speaker Fabian Nunez
AB 8--Health Care Coverage
- Does not include an individual mandate.
- Requires healthcare coverage for all workers and their dependents in businesses with two or more employees.
- Advocates "pay or play." Employers can pay for health insurance or pay a fee for coverage available through a state cooperative purchasing program.
- Promotes fair-share healthcare contributions among state and federal government, employers and employees.
- Expands Medi-Cal and Healthy Families for children and adults at or below 300 percent of federal poverty level.
- Restructures state's high-risk purchasing pool for individuals who are uninsurable.
- Requires insurers to offer uniform benefit plans in and outside of the cooperative.
- Promotes preventive care, disease management and pay for performance.

Senate President Pro Tem Don Perata
SB 48--Health Care Coverage
- Creates individual healthcare mandate for employed Californians.
- Requires healthcare coverage for all workers and their dependents.
- Supports "pay or play." Employers can pay for health insurance or pay a fee for coverage available through a Health Insurance Trust Fund.
- Promotes shared healthcare contributions among state and federal government, employers and employees.
- Expands Medi-Cal and Healthy Families for children and adults at or below 300 percent of federal poverty level.
- Establishes a purchasing pool for small employers and the uninsured.
- Creates incentives for preventive care, disease management and healthy lifestyles.

Sen. Shelia Kuehl (D-Santa Monica), Chair of Senate Health Committee
SB 840--Single-Payer Plan
- Creates universal healthcare for all.
- Allows each patient to choose his or her own physician.
- Replaces insurance companies with a state trust fund that collects premiums paid by employers and individuals.
- Promotes shared healthcare contributions among state and federal government, employers and employees.
- Prohibits most private health insurance from being sold.
- Advocates preventive care, administrative savings and performance measures.

Senate Republicans CalCARE (Choice, Affordable, Responsible, Effective)
Proposal associated with several bills not yet introduced at press time.
- Does not contain an individual or employer mandate.
- Offers employers tax credits and other incentives for providing insurance.
- Creates tax credits for physicians who provide charity care.
- Encourages more use of community clinics, less reliance on emergency rooms.
- Does not contain expanded access to Medi-Cal and Healthy Families.
- Eases regulator requirements on what products health insurers can sell.
- Boosts Medi-Cal rates.