Kim Belshé has been working to change the health care delivery system in California for years -- previously as the secretary of Health and Human Services under Gov. Arnold Schwarzenegger (R) and now as a board member of the Covered California health benefit exchange. She knows firsthand how much of a difference health care reform can make in California . And how much different that reform still needs to be. "There is a really challenging reality facing us and that is a recognition that near-universal coverage is, in fact, not universal," Belshé said at a recent conference in Sacramento .