After a string of victories that brought malpractice reform legislation only a few votes from passage, Senate Republican leaders last week began paring controversial provisions from the bill.
But Senate leaders said they may preserve a section of the bill that would limit providers' liability for noneconomic damages in malpractice cases to their share of the blame, a provision that is hospitals' top priority.
The malpractice reform measure, part of a broader bill to reform product-liability law, twice last week failed to get the 60 votes needed to stop a filibuster in the Senate. That prompted the GOP leadership to begin eliminating all provisions that did not have the support of enough lawmakers. The hope was that by stripping away the more controversial elements of the package, backers could gain enough votes to pass the core liability legislation.
Senate Majority Leader Bob Dole (R-Kan.) said parts of the malpractice section may remain in the bill, while Democratic Leader Thomas Daschle (D-S.D.) said there was a "strong possibility" that the provision limiting providers' exposure to noneconomic damages-or "pain and suffering" awards-would remain in the bill.
Republican leaders said they hoped to introduce a stripped-down bill early this week.
The Senate earlier last week voted 53-47 to add the malpractice measure to the product-liability reform bill.
Supporters of product-liability reform had cautioned against including a comprehensive malpractice measure in the bill because they believe it will create too much opposition.
Sen. Jay Rockefeller of West Virginia, chief Democratic sponsor of the bill, resisted adding the malpractice provision, saying it would "load down" the bill and cost it some necessary Democratic votes. Rockefeller voted against adding the provision.
A lobbyist for a coalition of provider groups was pessimistic about the chance of malpractice reform passing. Noting that the Senate fell 13 votes short of stopping debate, Frederick Graefe of the Washington law firm Baker & Hostetler said, "It's going to be an uphill fight to get anything."
Earlier in the week, the Senate defeated a measure that would have capped noneconomic damages at $500,000, a provision that the American Medical Association had been seeking.
But AMA officials said they have not been defeated in that fight because a House-passed version of legal reform included a $250,000 cap on noneconomic damages, which could be included in a House-Senate conference measure that reconciles differences in the two bills.
"The AMA will aggressively lobby the House-Senate conference committee to adopt the House medical liability provisions," said AMA Executive Vice President James Todd, M.D.