Family Health Plus has enrolled about 325,000 members, spurred in part by an aggressive TV advertising campaign featuring Pataki. New York City advertised a plan called Health Stat to get people signed up. It cost more than $2 billion last year.

The thinking behind that program and other taxpayer-backed plans, like Child Health Plus, which insures children whose families have incomes too high for Medicaid, is that providing them with insurance will in the long run save money and improve lives by reducing serious illnesses and also cutting down on the charity cases that hospitals have to treat.

But, as McMahon pointed out, there's no evidence yet that has happened, and in the meantime taxpayers are footing the bill.

Pataki's top health adviser acknowledged that Family Health Plus has grown significantly and its costs have to be reined in.

"That is why the governor proposed changes to the program to reduce its cost and make it more like the type of insurance most working families have,'' said the aide, Robert Hinckley.

Pataki has proposed eliminating vision and dental services from Family Health Plus, limiting assets, banning coverage for people who work for large organizations, requiring some co-payments and mandating a 12-month waiting period for those who had health insurance previously.

But key Democratic Assembly leaders have said they don't want to make those changes.

"It is a devastating package,'' Assembly Health Committee Chairman Richard Gottfried of Manhattan said of the Republican governor's proposal. "Governor Pataki's health-care budget would be especially cruel to working New Yorkers and their families, those least able to afford it.''

Hinckley also pointed out that the task force appointed by Pataki last year made recommendations that would "bring real reform to the system'' and deal with the lack of planning that Meier criticized.

Among other things, the task force recommended tightening restrictions on who qualifies for Medicaid, designing programs to help keep people out of nursing homes, expanding long-term-care insurance and having the state take over the local share of long-term-care costs.