SACRAMENTO – Comprehensive health care reform was once considered to be part of the electrified third rail of politics, bringing shock and pain to anyone who dared touch it.

Now, promoting major health care changes is getting safer.

Across the nation, governors and state lawmakers are following the lead of Massachusetts and California in proposing plans to cut soaring health care costs and cover many of the 46 million Americans with no insurance.

Kansas, Wisconsin, Illinois, Pennsylvania and Minnesota are among the 15 states considering major expansions in health care this year, according to the National Conference of State Legislatures...

From 2000 to 2005, the percentage of businesses in the United States offering health insurance dropped from 69 percent to 60 percent, according to a Kaiser Family Foundation study. Significantly, much of that decline took place between 2003 and 2005, at a time when the economy was adding jobs.

“People are worried about this in a way that's quite different from in the early 1990s,” said Len Nichols, health policy director for the New America Foundation, a centrist think tank.

Then a recession caused anxiety among the middle-class about health insurance, Nichols said. Those fears provided early momentum for the push by the administration of President Clinton for universal health care, spearheaded by then-first lady Hillary Rodham Clinton in 1993.

Nichols, who helped shape the plan, said once the economy recovered, people were not as concerned about losing health care coverage. Instead, they feared that an overhaul might force them to give up part of their health coverage...

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