Smith's office would not comment on whether he will offer changes to address the constitutional concerns stemming from the bill before a final vote this week, although Smith said in a statement that he remained “on course to take the bill to the House floor.”
Rep. Trent Franks (R-Ariz.), chairman of the committee's Constitution Subcommittee, said he expected “minor clarifications” to the bill to address the constitutional concerns.
The legislation would establish a three-year statute of limitations on malpractice lawsuits; limit noneconomic damages to $250,000; and assign damages based on proportional responsibility.
The friction over whether a federal law would or would not override state constitutions has not drawn concern from hospital and physician groups that are backing the House legislation. However, Dr. Cecil Wilson, president of American Medical Association, raised strong concerns to a different change requested by Democrats and which the panel's chairman said he would consider: indexing the damages cap to inflation. That is the kind of change that “could compromise the legislation's ability to rein in healthcare costs and fix our broken medical liability system,” Wilson said in a written statement.
Ultimately, opposition from tea party Republicans likely will fall far short of that expected from Senate Democrats, who have blocked numerous medical malpractice bills since the 1990s. Sen. John Ensign (R-Nev.) has introduced companion legislation, but it has yet to see any movement.
The Obama administration could pose additional obstacles. For example, HHS Secretary Kathleen Sebelius told reporters recently that she opposed several of the key components of the GOP bill. Her objections came despite President Barack Obama repeatedly expressing his willingness to collaborate with Republicans on liability reform. A White House official would not say if the president has a position on the Republican bill. When asked what medical liability approach Obama would prefer, a spokesman referenced a voluntary arbitration system then-Sen. Obama proposed in 2006.