The semi-retired Bountiful teacher also is too young for Medicare and earns too much to qualify for Medicaid. So in May, she turned to Utah's Comprehensive Health Insurance Pool (HIPUtah), a state-subsidized last resort for the uninsurable.

But less than a month after enrolling, Counter was told her monthly premiums were being raised from $641 to $733 - a fee that threatens to price her out of the only insurance option she has left.

Counter blames health giant Intermountain Health Care (IHC), which took over administration of the pool from Regence Blue Cross Blue Shield about the same time that the premium hikes were imposed.

HIPUtah executive director Tomi Ossana says the timing is a coincidence and that IHC won the pool in an open bidding process after submitting the cheapest offer.

HIPUtah was over budget and the premium increases, which ranged from 6 percent to 14.6 percent, were necessary to stem the tide, said Ossana. "We're not trying to gouge members."

But Counter wonders why she should pick up the tab.

"This isn't HIPUtah. This is hip, arm and a leg Utah," said Counter.

"We're told this is our last resort, that we're the great unwashed and uninsurable. Why should they get out of debt on my back?"

Ossana sympathizes with HIPUtah's 3,049 policyholders. But she says the insurer's financial troubles are the product of soaring health costs and an aging population, not mismanagement.

In the past four years, the insurer almost doubled in size, taking on more than 1,400 new policyholders. Claims have grown even faster than the number of enrollees.

"The people we cover are the sickest of the sick. Our population incurs double, sometimes triple the medical costs of the rest of the population," said Ossana, stressing the program pays $1.70 in claims for every $1 received in premiums.

This fiscal year HIPUtah collected $14.7 million in premiums, but spent $23.6 million on claims and other operating expenses, for a $8.9 million loss. Propped up by $16.2 million in permanent and one-time taxpayer money, the insurer has $9.2 million in reserves - enough to cover four months in outstanding claims.

Actuaries project the pool needs six months in reserves.

Ossana expects to have to ask the Legislature for another bailout this winter. Another option would be to permanently fund the pool through tobacco or hospital taxes.

Thirty-three states have risk pools similar to Utah's, which prop up the insurance industry by shouldering the risk.

But Pat Munson, who is enrolled in HIPUtah because of his chronic arthritis, feels abandoned by insurers, which he says are making millions at his expense. He and his wife Laurie's premiums have gone up from $300 each in 2001 to $562.

"If the price of insurance continues to rise at this rate, we'll all be out of luck," Munson said.

Countered Ossana, "You can look at it that way, or look at it like, 'Without this program I wouldn't have health insurance.'"

kstewart@sltrib.com