Legislation to create a universal health care system in California stalled in the state Senate Thursday ahead of a key legislative deadline, signaling it will likely fail to advance this year.

The so-called "Medicare for all" proposal, Senate Bill 810, fell short of the 21 votes needed to pass the upper house, by a vote of 19-15. Four moderate Democrats abstained and one joined Republicans in voting against the bill.

The Assembly, meanwhile, approved several health-related bills, including measures requiring private health insurance plans to cover costs of oral chemotherapy and the treatment of mental illness and substance abuse.

The apparent defeat of SB 810, which faces a Tuesday deadline for passing the Senate, was the latest setback for supporters of the single-payer movement, who have pushed the proposal multiple times in recent years.

The last version to win legislative approval was vetoed by then-GOP Gov. Arnold Schwarzenegger.

The bill's author, Democratic Sen. Mark Leno, said the system would stabilize health care costs and ensure all Californians have access to health care coverage.

He called the bill, which does not include funding to cover the projected $250 billion annual cost of the single-payer system, the first step in a "many-year project" that will likely require asking voters to approve financing.

"It makes sense to continue to keep this ball moving so we can have the debate, so we can better educate Californians as to what single payer is and single payer is not so that when it reaches the ballot they won't vote against their own health care interests," the San Francisco Democrat said.

Republicans said the proposal is misguided and would increase costs and bureaucracy at a time when the state can least afford it.

"This is just the wrong approach," said Sen. Bob Dutton, R-Rancho Cucamonga.

"I think it's a worthy goal, but the fact of matter is that this isn't going to solve your problem. It's just going to make our problems even worse."

Senate President Pro Tem Darrell Steinberg, D-Sacramento, told reporters after the vote that he didn't feel the bill had a shot at getting approved and signed into law this year.

"The single-payer movement, it's a movement and the bills are vehicles to give visibility to the issue," he said.

Democratic Assemblyman Jim Beall of San Jose crafted the bill covering mental health and substance abuse treatment, Assembly Bill 154.

It passed the lower house, 47-18, with no GOP votes and will now go to the Senate for consideration.

Current law only requires private insurers to cover severe mental illness, while AB 154 targets other types of disorders, including depression and substance abuse but not bereavement or anti-social behavior.

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Call Torey Van Oot, Bee Capitol Bureau, (916) 326-5544.