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KAI RYSSDAL: New York Governor Eliot Spitzer gave his first state-of-the-state address yesterday. He promised ethical reform and an end to corruption. That's how he made his political bones — as a crusading attorney general on Wall Street.

But then Spitzer struck what seems to be a developing theme among state governments: health insurance. Spitzer said he wants to guarantee access to health care for all of New York's uninsured children and help reduce the number of uninsured in the state overall.

Marketplace's Alisa Roth reports now on states stepping in where the Feds fear to tread.

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ALISA ROTH: Around 15 percent of New Yorkers have no health insurance. If the governor follows through on his plans, the state could cut that number in half — giving it some of the lowest numbers of uninsured in the country.

Diane Roland directs the Kaiser Commission on Medicaid and the Uninsured. She says some of Spitzer's proposals, like increasing coverage for uninsured children, are relatively straightforward.

DIANE ROLAND: One of the major obstacles to getting full coverage for all low-income children is making parents aware and facilitating the enrollment.

Likewise, the state could make it easier to get adults who are eligible for Medicaid to sign up and re-enroll by simplifying the bureaucracy.

In taking on the challenge of universal health care, Spitzer joins politicians like California's Arnold Schwarzenegger and former Massachusetts governor Mitt Romney. Many have applauded states' efforts to take up the job where the federal government has failed.

VICTOR FUCHS: These are very noble, you know, efforts and so on, but I just think they're not a good way to go.

Stanford health economist Victor Fuchs.

FUCHS: It's like putting Band-Aids on something which is really a deep wound that requires surgery.

He says the American health care system is too far gone, and any overhaul would need to start from scratch.

In any case, it's still early days for Spitzer and his colleagues. Most proposals so far have been very vague, and it'll be at least the end of the month before more information comes out.

In New York, I'm Alisa Roth for MarketPlace.