The House on Thursday passed, 229-196, a bill that would cap noneconomic damages, such as compensation for loss of a limb or sight, at $250,000. The bill would not limit compensation for medical bills, funeral expenses and other economic damages.
States still could pass legislation to exceed the bill's cap, but would have to have some sort of limit in place.
Already, some Republicans in the Senate, such as Arlen Specter and Rick Santorum of Pennsylvania, have expressed reservations about the House cap.
Thursday, House Republicans seemed to concede they would have to negotiate the limitations.
There is no particular magic in $250,000 as opposed to $350,000," Rep. Roy Blunt of Missouri, the No. 3 Republican in the House, said after the vote. Blunt said the goal was simply to put patients first.
Even the measure's author, Rep. Jim Greenwood, R-Pa., admitted that House negotiators would need to be flexible with the Senate, which means "the bill will not be as good."
But Greenwood added, "They (the Senate) have a moral obligation to pass something."
President Bush, who long has pushed for such limits, lauded the House action.
"Today's House vote is an important step toward creating a liability system that fairly compensates those who are truly harmed, punishes egregious misconduct without driving good doctors out of medicine and improves access to quality, affordable health care by reducing health care costs," Bush said in a statement.
The issue of medical malpractice caps has pitted two powerful political constituencies against one another: trial lawyers and health providers. The lawyers argue they are being made into bogeymen, and the caps won't reduce insurance rates but will leave Americans who are damaged by medical mistakes unable to recoup their full losses.
The American Medical Association, which represents doctors, says 18 states are in a crisis because of the liability problem. Doctors have taken to protests and rallies to show their displeasure.
Doctors in Florida, Mississippi and West Virginia temporarily stopped some patient services. Last month, physicians in New Jersey withheld routine treatments for several days to protest ballooning malpractice insurance rates.
Last summer in Nevada, doctors temporarily closed the top level trauma center in Las Vegas, forcing critically injured patients to be transferred.
There have been numerous reports of doctors dropping high-risk specialties such as obstetrics to lower their liability risks.
In Congress, there is agreement that there is a problem. Democrats argue, however, that caps will do little to combat rising insurance premiums and will instead increase profits of the insurance industry. The bill further harms victims of malpractice, Democrats argued.
Rep. Sheila Jackson Lee, D-Texas, said the measure was "an insurance giveaway bill."
In addition to the cap on noneconomic damages, punitive damages - those that punish a physician for serious mistakes - would be limited to twice the amount of economic damages awarded or $250,000, whichever is greater.
The legislation also would restrict patients' ability to file lawsuits over old cases and set limits on lawyers' fees. The bill would affect not just doctors but also hospitals, nursing homes and other health providers.