The full U.S. Senate late last week began debating malpractice reform legislation after Republican backers hit some unexpected snags in committee.
Sponsors resuscitated the legislation, which had been nearly gutted by the Senate Labor and Human Resources Committee. The panel stripped a $250,000 cap on punitive damages from the legislation and also gave states the authority to opt out of the federal law if they pass their own malpractice measures.
However, backers of the weakened, committee-approved measure vowed to press their case before the full Senate and seek to have their work substituted for the original measure.
That measure contains caps on punitive damages and provisions pre-empting state laws.
And in cases with several defendants, it limits a provider's liability for noneconomic damages to the proportion of blame a judge or jury assigns to that provider.
It does not, however, include the $250,000 limit on noneconomic damages, a provision that physicians have been seeking. Some malpractice reform proponents argued that keeping the provision would spark too much opposition and kill the legislation.
The strains in the coalition pushing for malpractice reform showed last week as the American Medical Association continued to lobby for the cap on noneconomic damages, which is not a high priority for hospital advocates.
The difficulties surrounding the legislation also were demonstrated when the state opt-out provision, sponsored by freshman Sen. Spencer Abraham (R-Mich.), was approved by the Labor and Human Resources Committee.
As a sign that Abraham's provision spells trouble for malpractice reform, six of the committee's seven Democrats joined Abraham, a state rights advocate, and only two others of its nine Republicans in voting for it.
"The strong props have been sort of knocked out of it," acknowledged Sen. Nancy Kassebaum (R-Kan.), chairwoman of the committee and a sponsor of the malpractice bill.