Medi-Cal delay.

Gov. Arnold Schwarzenegger appears to have met his match in the state Medi-Cal program and its attendant hospital lobby.

After first promising to unveil a redesign of the $31 billion health program serving the poor, aged and disabled in the spring, and then this month, the governor backed off last week--and has now put off any plan until January.

The official reason from the state Department of Health Services is that the massive program has proven far more difficult to overhaul than first thought.

Another likely reason: details of the proposed redesign being leaked out indicate that hospitals serving the poor would stand to lose up to $1 billion out of $2 billion in current funding.

"The numbers just didn't work out," said Sherreta Lane, vice president for reimbursement with the California Healthcare Association, the hospital industry trade association.

The aim of the redesign is to cut the growth of the Medi-Cal program, which covers 6.7 million residents and now consumes 14 percent of the state general fund. Among the controversial proposals on the table include moving recipients to managed care and requiring others to pay monthly premiums or office-visit co-pays.

But what appears to have mucked things up is a proposal that would have forced hospitals to certify their exact Medi-Cal spending, the cumulative total of which would then be used to draw down federal matching funds.

Under the current system, in which a different formula is used, California hospitals serving the poor draw down more funding than they can certify. But they use the funds to help pay for care for indigent patients--those unable to pay for hospital services even though as low-income single adults, for example, they don't qualify for Medi-Cal.

Also, a Democratic win in November would mean a new team at the federal Centers for Medicare & Medicaid Services, which must approve any changes to the Medi-Cal system.