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SANTA FE — It may not be too far-fetched: health care reform derailed by the Rail Runner Express.

What Gov. Bill Richardson wanted most out of the just-ended legislative session was a plan to provide all New Mexicans with health coverage.

It didn't even come close to passing.

There are a host of reasons why. For starters, shaking up New Mexico's $6 billion health care system is a big, complicated, potentially expensive undertaking, fraught with uncertainties.

"The big issue, the very first one, is how do you do it," said House Majority Leader Ken Martinez, a Grants Democrat.

"Do you do it by the government coming in and taking care of the apparatus, or do you use the existing apparatus and have the government kind of oversee that? That's huge right there," Martinez said in an interview after the session.

Richardson's plan relied on the existing private-insurance system. New Mexicans would be required to buy insurance, and employers that didn't offer it would have to pay into a fund to make insurance more affordable. Government programs would be expanded.

The House barely passed the plan — after gutting it by removing the mandates. It then tanked in the Senate, failing to get even a committee hearing.

A refrain from Senate leaders was that they were worried about the cost and weren't sure they could rely on the Richardson administration's figures.

Senate Finance Chairman John Arthur Smith, a Democrat from Deming and a fiscal conservative, said revenue growth is declining and the competition for dollars — for schools, roads and the retiree health care system — is getting keener.

In addition, he says, "The trust has been misplaced."

Many lawmakers are still shell-shocked by the cost of the Rail Runner Express, the administration-created commuter rail system that runs between Belen and Bernalillo and is supposed to reach Santa Fe by the end of the year.

They maintain they weren't given enough information about the expense of it when they gave the go-ahead in 2003 as part of a highway funding package. It's now estimated at $400 million.

The Rail Runner is "off the wall," said Senate Republican Leader Stuart Ingle of Portales. "We'll be lucky if it's $500 million. Nobody knows; that's the problem. And we can't deficit spend."

The administration's cost estimates for the health plan fluctuated wildly right before the start of the session. A contractor studying health coverage options at first estimated it would cost an additional $75 million in the 2010 budget year, and an extra $333 million over five years. Two weeks later, those figures were reduced to $30 million and $72 million, respectively.

The contractor blamed a computer error, but it provided fodder for lawmakers already leery of the proposal.

Richardson doesn't buy the argument that questions about costs and mistrust of his administration were key to the failure of his proposal.

In an interview, he called it a "lame-brained excuse."

"I think they're afraid to act on health care because of too much political heat" from lobbyists, he said.

There was no shortage of lobbyists, on all sides of the issue — businesses, health care plans, doctors, insurance companies, activists, ordinary citizens with harrowing tales of how the health care system has failed them.

The governor's plan had a core of support — among them the Greater Albuquerque Chamber of Commerce and the big health management organizations that contract with the state.

It also had detractors from all sides. They complained it was too much reform — harmful to small businesses, for example. Or not enough reform — propping up insurance companies without getting at the problems of the quality and affordability of health care.

"This is not an easy subject, and there's the potential for making big mistakes that affect people's lives," said Sen. Dede Feldman, an Albuquerque Democrat. "So the first lesson is, do no harm."

One thing many lawmakers agree about was the educational value of it all.

"I think there are 112 of us that know a whole lot more about health care than we did a year ago," said House Republican Leader Tom Taylor of Farmington.