SACRAMENTO — Spurning Gov. Arnold Schwarzenegger's proposal to guarantee health insurance for all Californians, Republican leaders in the state Senate offered a far more modest alternative Tuesday, intended to increase clinics for the poor and encourage the purchase of high-deductible policies covering catastrophes.

The plan aspires to make medical care and insurance easier to obtain for about 1 million of the state's 6.5 million residents who do not have insurance. But unlike the proposals from Schwarzenegger and the Democrats who control the Legislature, it would not require employers to provide coverage. Neither would it require that everyone in the state obtain insurance, as Schwarzenegger wants...

The proposal would expand tax credits to encourage employers to offer insurance plans for their workers and to promote the use of health savings accounts that allow people to set aside some of their earnings to pay for medical care without paying taxes on that income. Created by the Bush administration in 2003 and now a cause celebre in GOP circles, such accounts are for people who buy insurance plans that pay only for catastrophic illnesses...

Peter Harbage, a healthcare expert with the New America Foundation, a think tank that Schwarzenegger relied upon for parts of his plan, said he was surprised that the Republicans dismissed the notion of aiming for universal coverage.

"There seems to be so much momentum," Harbage said. "There's a role for tax breaks, but just saying to people, 'Here, go off and buy insurance,' that's not going to help anybody."

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