The legislation, which could be voted on today or Friday, would let small businesses join together to buy health insurance out of state for their workers, a move that Senate Republicans argue would bring less expensive care.

But Democrats - along with 41 state attorneys general, several insurance commissioners and a laundry list of big-name nonprofit groups - oppose the bill, saying it puts at jeopardy health insurance for millions. The legislation, as proposed now, would let businesses use out of state regulations covering the health plans.

In Utah, that could mean businesses could offer health plans that don't include treatment for alcoholism and drug abuse, mental health disorders, metabolic disorders and supplies, and education on diabetes, according to Families USA, a group that promotes broader health coverage.

The bill is part of a Republican push to bring health care issues to the fore this week that the Senate has dubbed "Health Week." The Bush administration backs the bill but its fate in the Senate is uncertain.

Shurtleff sent a letter to all 50 senators as part of the National Association of Attorneys General that argues the legislation, by Sen. Mike Enzi, R-Wyo., would supercede state law and that past experience has shown that "exempting plans like this from state law harms consumers."

The letter, signed by Republicans and Democrats, concludes that, "Consumers rightfully expect their state government to require a minimum of health benefit protections and to protect them from abuse by health care insurers. Elimination of strong state protections in exchange for weak federal oversight fails consumers."

Utah Insurance Commissioner D. Kent Michie said in a letter to Hatch and Bennett that he tried to understand the bill and those who support it, but cannot recommend voting for the measure.

"I have yet to find one single commissioner of insurance from any state who is in favor of the bill on its merits," Michie wrote.

Michie also argued that under the legislation currently insured workers would be "forced out" of the private health care market, state oversight would be gutted, there would be increased fraud and abuse, and the bill "will not reduce the number of uninsured people in Utah or the United States and in fact will cause that number to increase."

Hatch disputed criticism of the bill this week during a floor speech.

"We cannot afford to sit by the sidelines and bemoan this problem, taking little action while millions of American families suffer," he said, then taking after naysayers who charge that the legislation would mean less coverage.

"Those who decry this bill because it does not guarantee small business employees a comprehensive plan, must be reminded that most employees of small businesses do not have a choice today, if they are fortunate to have health insurance coverage. The legislation before the Senate will create new options for small businesses and the potential for more choices for their employees."

Bennett spokeswoman Mary Jane Collipriest says her boss will support Enzi's bill because it "will give small businesses the opportunity to offer health coverage to their employees and increase the number of insured Americans."

tburr@sltrib.com