L A Care Health Plan

Seven nominees for the new board of directors of the private, nonprofit Martin Luther King Jr. Hospital were announced by Los Angeles County's chief executive and University of California officials Thursday, the latest step toward reopening the hospital in 2013. All of the nominees have more than a decade of experience in healthcare, business or law. The nominees: —Manuel A. Abascal, a partner at Los Angeles-based Latham & Watkins —Dr. Elaine Batchlor, chief medical officer of L.A. Care Health Plan —Linda Griego, president and chief executive of Los Angeles-based Griego Enterprises Inc. and a former Los Angeles deputy mayor —Paul King, president and chief executive of Childrens Hospital Los Angeles Medical Group —Michael Madden, a retired former chief executive of Providence Healthcare of Southern California —Dr.

A veteran educator was appointed Thursday to head an ambitious plan to spend $100 million in tobacco taxes to provide universal preschool in Los Angeles County. Karen Hill-Scott, co-founder of the Los Angeles child care agency Crystal Stairs, will be charged with implementing a 10-year project to provide free, full-day preschool to more than 100,000 3- and 4-year-olds in the county.

If the Supreme Court scraps the Affordable Care Act in the coming days, California will lose out on as much as $15 billion annually in new federal money slated to come its way, dealing what state officials say would be a critical blow to efforts to expand coverage to the poor and uninsured. The state is one of the biggest beneficiaries of the federal healthcare law because of its large number of uninsured residents - about 7 million people, or nearly 20% of California's population.

It has been more than two years since Vianey Lopez has seen the inside of a doctor's office. When her father lost his farm job and a new assembly-line position provided no health insurance, the 17-year-old Oxnard student said medical care became a luxury her family no longer could afford.

The cable TV channels fired their screeching engines hours in advance. A "Health Care Make or Break Moment" screamed a CNN headline. Countdown clocks at Fox and MSNBC ticked inexorably toward 00:00, the moment when President Obama would face down a joint session of Congress. This had to be really, really big, I learned all day Wednesday from the excitable people on cable TV -- a speech that likely would determine the fate of healthcare reform and, perhaps, the Obama presidency.

Amid the cheering in many quarters over the Supreme Court's decision to uphold the federal healthcare law, a sobering fact remains: California's ailing healthcare system won't be easy to fix. Millions of Californians will still lack insurance even after a massive coverage expansion. Medical costs and premiums are expected to keep rising, at least in the short run. And many of those who do gain coverage could have a tough time finding a doctor to treat them. "The implementation challenges are huge and the expectations for cost control are unrealistic," said Arthur Kellermann, a physician and director of Rand Health, a nonprofit research group in Santa Monica.

Access to affordable healthcare in the United States is an entitlement, a perquisite or a fantasy, depending on a seemingly arbitrary matrix of factors. Government insurance programs are available for the elderly, the permanently disabled, people with failing kidneys, the impoverished and children from low-income families. But how poor one has to be to qualify varies from state to state and from year to year.

With the state government considering deep cuts in health programs to address its budget shortfall, Gov. Gray Davis has asked the Bush administration to allow California counties to tap tens of millions of available federal dollars to cover uninsured children.

Half a million elderly, blind and disabled Californians now enrolled in Medi-Cal -- including all of those in Los Angeles County -- would be shifted into managed care as part of a complex deal with the federal government, the Schwarzenegger administration announced Wednesday. The pact dictates how California can spend $18.4 billion in Medicaid money over five years and amounts to an overhaul of hospital financing in the state.