SACRAMENTO, Calif. — Gov. Arnold Schwarzenegger pledged California's full support Thursday for national health care reform, throwing the weight of one of the nation's most prominent Republicans behind an overhaul that caused a deep political divide and prompted at least 18 states to file legal challenges.
Schwarzenegger said he has long supported the concept of universal health coverage, and in 2007 proposed a $14.7 billion overhaul of the health care market in California.
That effort failed in part because of concerns over cost, but the governor credits the effort with helping lay the groundwork for the federal bill signed this year.
Schwarzenegger said it's time to set politics aside and start implementing the new law, even as many cash-strapped states worry the costs of the overhaul will widen their budget shortfalls.
"The bottom line is that the plan is not without flaws," Schwarzenegger said during a news conference at a University of California, Davis cancer center in Sacramento. "But it is a good law. And it is the time for California to move ahead with it, thoughtfully and responsibly."
The Republican Governors Association said it believed Schwarzenegger was the first GOP governor to come out strongly in favor of the health care reform law.
Schwarzenegger's comments marked a change in tone from earlier this year. After the U.S. Senate had passed its own version of the health care bill, which has since been revised, Schwarzenegger was among many critics who lambasted a provision that gave Nebraska additional Medicaid money.
The move was widely seen as a way to secure the vote of Nebraska Sen. Ben Nelson. At the time, Schwarzenegger called the bill "a rip-off."
Schwarzenegger spokesman Aaron McLear said the governor still has concerns about the potential costs to California of implementing the plan and how the state will administer it. California already faces a $20 billion deficit over the next 14 months.
During the news conference, Schwarzenegger said reform measures would cost the state between $2 billion and $3 billion a year, but the full costs would not kick in for seven years, giving the state time to figure out how to pay for them.
U.S. Secretary of Health and Human Services Kathleen Sebelius said she welcomed Schwarzenegger's support and his dedication to strengthening the health care system.
She said the Obama administration has made progress in protecting consumers and lowering costs since the president signed the bill.
"This is a very state-friendly law and our administration has worked closely with governors to both pass and begin implementation of it," Sebelius said in a statement.
Schwarzenegger's move could have broad consequences for the state and for the success of the national reform effort. The nation's most populous state also has the highest number of uninsured residents in the country, roughly 8.2 million, a number that has swelled by 1.8 million during the past two years because so many Californians have lost employer-based health insurance during the recession.
Schwarzenegger said that reality is placing an enormous strain on uninsured families and on the state economy. Deep state budget cuts in recent years also have left tens of thousands of poor, vulnerable residents with severely reduced coverage.
California will take several immediate steps to begin implementing the federal plan, including the formation of a health care reform task force, the governor said.
The steps also include contracting with the federal government to operate a new high-risk pool for people who have been refused coverage, and developing a purchasing pool so small businesses and individuals can shop for health insurance at competitive rates.
In addition, state agencies will begin enforcing some of the cornerstones of the federal law, such as removing lifetime dollar limits on health insurance payouts, allowing children to stay on their parents' policies until age 26, preventing insurance companies from denying coverage to children and banning retroactive policy cancellations.
Schwarzenegger said the initial steps will be fully funded by the federal government. He intends to convene a special session of the Legislature if legislative action is necessary.
Schwarzenegger said society is paying a high price for the uninsured. Those who don't have health insurance, he said, in effect force others to pay for their medical care when they are injured or become ill.
"Today a lot of people (are) asking me, 'Why are you so adamant about health care reform and you are a Republican governor? That's not a Republican issue. Republicans don't like it,'" the governor said as a line of doctors in white coats stood behind him.
"I say to them, well, the bottom line is I don't see it as a Republican issue or a Democrat issue," he said. "I think that everyone needs health care insurance. Everyone needs to be covered. Everyone ought to have access."
The two Republicans contending for the right to succeed Schwarzenegger after he is termed out of office next year have a different view of the federal law.
Former eBay chief executive Meg Whitman and state Insurance Commissioner Steve Poizner agree with national Republicans' "repeal and replace" approach and say they will work to overturn the law if elected.
Whitman would encourage the California attorney general to join the lawsuit filed by other states, saying the overhaul could cost California $3 billion and devastate small businesses, said her campaign spokeswoman, Sarah Pompei.
Poizner's campaign spokesman, Jarrod Agen, said the insurance commissioner believes the overhaul will be a financial burden on California while doing nothing to address rising health care costs.
Associated Press Writer Samantha Young contributed to this report.