Healthcare is a constant struggle for Michelle Moulton, who owns a small painting contract business in Sammamish, Wash., with her husband, Marion.

A couple years ago, Michelle was misdiagnosed with an immune disorder and had to undergo chemotherapy treatments. High insurance prices had priced them out of a comprehensive plan, so her family was underinsured and racked up nearly $30,000 of debt.

Now she can't get on a better insurance plan because of her medical history.

"I couldn't afford cancer if I got it," Moulton said. "I don't think people in the state should have to deal with that."

Lawmakers started this session with the goal of working toward universal healthcare coverage for all Washington residents by 2012. But a measure that supporters say would have set the state on that path has basically been whittled down to a pilot program and two studies.

"We have a lot more work to do before that's going to happen in 2012, but at least we're taking a step," said state Rep. Eileen Cody, chairwoman of the House Health Care and Wellness Committee.

Lawmakers are touting several healthcare successes this session: An omnibus bill based on recommendations of the governor's Blue Ribbon Commission on Health Care Costs and Access is still alive, and Gov. Chris Gregoire has signed a bill that would provide healthcare coverage to 38,000 more children in the next two years.

But a bill loosely based on Massachusetts' landmark healthcare initiative, which made it the first state in the country to require every citizen to have health insurance, was cut down significantly. (In Hawai'i, the state's Prepaid Health Care Act requires companies to provide health insurance for employees working at least 20 hours a week for four consecutive weeks.)

The original bill called for combining individuals, small-business and government workers, people on state-subsidized plans and individuals who receive health coverage through associations into a single consortium. Supporters said insurance companies would compete to represent such a large pool.

A state board would act as the "connector" between people and insurers.

Cody, who sponsored the bill, said the idea was to move the state away from an employer-based healthcare system. Employers would still contribute to a worker's plan, but individuals would decide what plan works best for them and their families.

"It changes the model so the individual is closer to the product and gets to make the choices," Cody said.

But that much change, even Cody acknowledges, can scare people. When the bill received its first public hearing this session, the room was jam-packed.

Business groups, such as the Association of Washington Business, warned that Washington should wait to see how the idea worked in Massachusetts before shaking up the system too much.

A scaled-down version of the bill, which passed out of the Senate last week, would remodel the existing small-employer health insurance partnership into a pilot program of the "connector."

Small employers who have at least one low-wage worker will be able to purchase coverage for all their employees through the state board. The board will set the minimum amount of a premium. The employer's contribution will be pooled with employee contributions.

The board would then negotiate with insurers for the best rates.

Supporters say the partnership has two advantages: It would allow employees to keep their insurance if they switch jobs, and the money that employers contribute would not be taxed.

If the pilot program is successful, it could be expanded to more markets, such as individuals who receive health coverage through associations and government workers.

Washington state Sen. Cheryl Pflug, the ranking minority member on the Health and Long-Term Care Committee, has called the idea a "New York Stock Exchange" of health insurance, where the individual goes to buy different insurance packages.

But changing to a consumer-driven market has been a struggle.

"Right now we've got the employers, the insurers and the government trying to hold the reins," Pflug said. "You can't get to a consumer-driven market with all the big guys holding the reins."

For people like Moulton who wants answers now, sitting around and waiting for lawmakers to act is just about her only option.

She has lobbied in Olympia on healthcare issues and testified in front of the Blue Ribbon Commission.

But she's still not sure if lawmakers fully understand.

"I don't think they really realize how fast people can be financially ruined," she said.