Patients wait weeks for brain scans, and pregnant women must change doctors every time an employer changes health plans, he says.

But a pragmatist by nature, Hellewell also understands Utah politics.

So, on Thursday, the Orem Republican put his bill - to limit IHC's market share and let patients see any doctor they want without penalty - in the hands of two moral crusaders, who promptly shepherded it out of committee.

Sen. Chris Buttars, R-West Jordan, the bill's new sponsor, removed a provision that would stop IHC from leasing its doctor panel to other insurance companies, while Utah County phone-tree maestro Gayle Ruzicka rounded up patients eager to tell their stories.

Along with disgruntled doctors, they persuaded the Business and Labor Committee to support the bill despite objections from powerful lobbyists who said the mandate, if adopted, will drive up premiums and harm Utah employers.

Senate Bill 34, dubbed Patient Choice Reform, now moves to the Senate floor with surprising momentum. With 14 co-sponsors already on board, the bill needs just one more vote to advance to the House - quite a turnaround for a measure that last year died before its first public debate.

Like last year's legislation, SB 34 would let patients go to any doctor or hospital willing to treat them as long as those out-of-network providers accept slightly less than what in-network doctors receive. But Buttars' bill also prevents providers from billing patients for the balance, and it ups the reimbursement rate to 95 percent.

Utah law already requires preferred provider plans to pay out-of-network doctors at 70 percent the discounted rate.

That will increase by 25 percent under SB 34, and insurance costs will rise as a result, said Kelly Atkinson, director of the Utah Health Insurance Association.

The bill also undermines the ability of insurance plans to negotiate discounts with IHC and other health maintenance organizations because those deals depend on the ability to steer patients to specific providers, opponents said. Because closed-panel plans tend to be less expensive, they are especially popular with small-business owners.

But such concerns were outweighed by testimonials from people such as Sandy orthopedic surgeon Paul Winterton. He called the current system "dehumanizing," and held up files of patients whose health was compromised by their insurance plans.

The legislative fiscal analyst, who is sifting through competing studies, has yet to determine if the bill will cost the state any money. But for now, proponents are savoring Thursday's win.

"These are the people with the big bucks and all the collateral," said Ruzicka, referring to the insurance industry, of which her husband is a member. "And the citizens came in here and carried the day."