SACRAMENTO—A bill to create a universal health care system run by an elected commissioner began its second attempt to reach the governor’s desk, five months after voters narrowly defeated an attempt to require employer-based coverage.

The legislation by Sen. Sheila Kuehl, D-Santa Monica, that was approved by a committee Wednesday would replace private insurance plans and also extend coverage to approximately 7 million Californians who have no health insurance.

Kuehl’s proposal passed the Senate in 2003 in a scaled back form but never made it out of the Assembly. It was overshadowed by legislation to require large and midsize employers to help pay for health insurance for their workers, a step supporters said would cover about 1 million of the uninsured.

That bill was signed into law by former Gov. Gray Davis but was invalidated by voters last November when they narrowly rejected Proposition 72 in a referendum that was placed on the ballot by employer groups.

On Wednesday, the latest version of Kuehl’s bill passed its first test, winning approval from the Senate Banking, Finance and Insurance Committee on a 7-4 vote, despite claims by opponents that it would lead to higher costs and bigger bureaucracies.

“This type of system is ripe for cost overruns, which would ultimately lead to higher taxes for all Californians,” said Trudi Hughes, a lobbyist for the California Chamber of Commerce.

Kuehl said it would actually save money. She pointed to a study by the Lewin Group, a Virginia consulting firm, that predicts the legislation would save California $343.6 billion in health care costs over the next 10 years, mainly by cutting administration and using bulk purchases of drugs and medical equipment.

The study was paid for by Health Care for All—California, a nonprofit group that supports universal coverage.

“The claims that it is less efficient cannot be substantiated,” Kuehl said.

Sen. Kevin Murray, D-Culver City, said he doubted that Kuehl’s proposal would be any worse than the private health insurance system. “We could not screw it up any more than it has been screwed up by a lot of business people,” he said.

Sen. Jackie Speier, D-Hillsborough, said Medicare is a single-payer system like Kuehl’s that has worked.

“While I am sure there are problems with it, it does provide a quality of care so we don’t have millions of senior citizens without health insurance,” she said.

Sen. Jeff Denham, R-Salinas, said Kuehl’s bill could lead to an exodus of doctors from California. “We have a broken system today,” he said. “Replacing it with another broken system makes no sense to me.”

But Kuehl said her plan would assure that physicians actually receive payments for their services. “Nurses support this bill,” she said. “Doctors concerned about reimbursement support this bill.”

Opponents, citing figures from government-run health care systems in Canada and Europe, also said Californians could face longer waits for medical care under Kuehl’s plan than they do now.

But Sen. Jack Scott, D-Pasadena, said those countries have lower infant mortality rates and longer life expectancies than the United States does.

“If you’re wealthy in America we have the best health care system; if you’re poor we don’t,” Scott said.

Speier criticized business groups that spent about $20 million to defeat Proposition 72 and then opposed Kuehl’s bill.

“All we hear from the opposition is, ‘Just don’t do this; just don’t do this,’” she said. “We are all going to get fatigued by those who say no but have nothing for an alternative.”

“We are concerned about access to care,” replied Maureen Higgins, a lobbyist for private health insurance plans. “I guess our approach is more incremental than you like.”

Wednesday’s vote sent the bill to its next stop, the Senate Health Committee.

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On the Net: Read the bill, SB840, at www.senate.ca.gov