Christensen, who said he is one of two specialists in his area, has a patient from Utah Valley because he is a paneled provider for a particular insurance plan. Conversely, he said he has many would-be Ogden patients he has to send elsewhere because he's not on their insurance plan.

Critics, however, say an AWP law would dismantle health maintenance organizations that contract with selected doctors, hospitals or other providers in networks that agree to discounted rates in exchange for a high volume of patients.

While SB34 is commonly said be aimed at Utah's health care giant, IHC, the Utah Health Insurance Association has come out against it, as well as BlueCross BlueShield, which says it will dramatically increase its costs.

It is those alleged costs — to the state or otherwise — that may lead to the bill's downfall.

After the debate, Senate President John Valentine, R-Orem, conceded SB34 may not pass when it comes up for a final vote. "It's almost too close to call," he said, noting a number of senators who gave preliminary approval for the bill indicated they may change their votes.

Valentine said senators are "having a hard time trying to decide whether patient access or cost is more important."

He said the cost to the state is $2.4 million to cover the increase to the state employees' insurance program.

The money to cover the increase in state employees' insurance costs would have to come from whatever boost to their benefits is approved this session. Valentine said that the bill would increase state employees' premiums by about 1 percent.

Supporters dispute that, saying health insurance companies ultimately control their own costs at the expense of patients who are often left with little choice over their care.

"It is about costs, but whose costs is it going to be?" said Sen. Parley Hellewell, R-Orem, the original sponsor of the measure.

While Jenkins and others argued lawmakers need more time to study the issue, Sen. Lyle Hillyard, R-Logan, urged his colleagues to move SB34 onto the House.

"You are not going to get any change in the system until you pass this bill. We have a chance of making a difference in health care," he said. "The people are just tired of this. . . . The answer is we need to step forward."

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Contributing: Lisa Riley Roche

E-mail: amyjoi@desnews.com