With the biggest protest rally so far this session assembling outside, debates over the influence and perhaps the future of Utah's largest medical care provider got under way Friday at the Capitol.

Lawmakers Friday morning launched into a heated but inconclusive first round of deliberations over whether Intermountain Health Care should should be taxed.

The dominance of Utah's health-care giant was the center of a Senate floor debate of a bill to allow Utahns access to any willing medical care provider instead of restricting them to only doctors offered through their insurance plan.

Saying IHC has gotten too big not to tax, Sen. Mike Waddoups, R-Taylorsville, has proposed a 3 percent tax on the health-care giant, an assessment that would generate $100 million a year for the state's uniform school fund.

But the several hundred at the rally and other IHC advocates believe that tax would raise health-care costs for everyone and essentially bring to an end IHC's annual expenditure in charitable care.

Company administrators say in 2004, IHC handled 150,000 cases totaling $67 million in donated care.

Angie Fedderson, South Jordan, an IHC policy-holder, said the bill would be "bad for Utah and bad for health care," adding that lawmakers might be basing decisions on bad feelings, not on good policy.

"I hope our voice is heard in there," she said.

Several people at the rally, which was vocal at times but never unruly, said they were at the Capitol to make sure those inside who will ultimately vote on SB61 will be held accountable at the next election.

A handful of doctors from a Utah County family medical clinic and wearing white coats, said their concern was more for the residents of Utah, not just their IHC co-workers.

"It would raise premiums and cut insurance providers," Michael Rhodes said. "Many employees at IHC work for the benefits and this would force them to drop coverage."

Kelli Campbell, an IHC employee, said, "This bill goes against every IHC core value that we have . . . and it would take away the ability to donate much-needed care."

IHC circulated petitions to recruit people to rally against the bill. Several employees said they were missing work to attend the rally.

"I hope they look at us and see what they're actually doing to Utah," Campbell said.

Whatever they're going to do, it won't be known until next week at the earliest. After two hours of testimony, a substitute proposal was made to split up IHC and not impose the tax.

IHC employee Leslie Marsh, who had come to the hearing hoping to allay fears that her job might be at risk under the bill, was obviously frustrated by the last-minute change.

"I think it's rude to substitute at the last second and change to a new issue," Marsh said. "It's sneaky and underhanded."

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E-mail: wleonard@desnews.com