The bill would have Utah join an interstate compact seeking to opt out of federal health reform and to let states control programs such as Medicaid and Medicare with federal block grants.
"We are the best managed state in the nation. We can manage these dollars better," Adams said, arguing that money could be saved through innovation now hindered by federal red tape.
But Sen. Pat Jones, D-Holladay, worried those grants would not keep up with inflation and that opting out of Medicare would be too risky with too many questions unanswered.
"It's bound to cost us more money," she warned, "either in raising taxes or to lower services for our seniors."
Sen. Aaron Osmond, R-West Jordan, said his constituents fear a loss of medical benefits and acknowledged "that is a possibility. But … it's also possible that unless the federal government acts, those benefits are going to be reduced anyway," he said, adding that the bill creates pressure for action.
"I see this bill as purely a message bill ... to Congress that says Utah can manage its affairs better than the federal government can," said Sen. Allen Christensen, R-North Ogden.
Other Republicans noted it would not take effect unless Congress passed additional legislation to allow it and added that Utah has time to back off if needed.
Sen. Gene Davis, D-Salt Lake City, said it is not just a message bill but ties Utah to a compact seeking to get out of health care reform and Utah might just get its wish in a way that could hurt Medicare and Medicare funding and services.
"It's scary," said Sen. Luz Robles, D-Salt Lake City.
Although Sen. Lyle Hillyard, R-Logan, backed the bill, he asked if it may not be wiser to wait a year to see if the U.S. Supreme Court upholds the federal Affordable Care Act and whether elections change power in Washington in such away that health reform would be reversed anyway.
But Adams said the time to act is now. "We ought to be on the forefront of trying to craft and direct this rather than be on the caboose."
Sen. Pete Knudson, R-Brigham City, said a message bill is needed and noted Medicaid's rising costs are biting into the state budget. "You have to express your concerns on what is happening."
Groups supporting the bill include the conservative Sutherland Institute and Utah Eagle Forum. Among opponents are AARP-Utah, the American Cancer Society, Utah Association of Home Care and Hospice, the Coalition for People With Disabilities and the Utah League of Women Voters.