Updated

Legislation that would limit damages for medical malpractice (search) passed the House on Thursday for the third consecutive year.

The bill, approved by a vote of 230-194, would cap awards for pain and suffering at $250,000. There would be no limit on economic damages, which provide reimbursement for such expenses as medical bills and lost wages. Finally, the bill would in many cases cap punitive damages at $250,000.

Supporters of the caps say they will stabilize malpractice insurance premiums. Many in the health care industry say the rising premiums have forced some doctors out of business, or forced them to move to states where caps exist. At the very least, they say, increasing premiums substantially add to the cost of health care.

The legislation was largely supported by Republicans with backing from doctors, hospitals, insurers and pharmaceutical manufacturers. The opposition came mostly from Democrats with backing from attorneys and some consumer advocacy groups, who said victims of malpractice would be prevented from obtaining fair compensation for their injuries.

The future of the legislation is in doubt despite Thursday's events. The Senate has so far declined to pass a bill that would cap punitive damages. In addition, such legislation would move through the Senate Judiciary Committee before moving to the full Senate, and that group of lawmakers already figures to have a full plate this fall dealing with the vacancy on the Supreme Court.

Democrats portrayed supporters of the bill as protecting influential interest groups at the expense of the average citizen.

"Are you so in bed with the drug companies and the insurance companies that you just can't pass up another opportunity to give them money?" Rep. Marion Berry, D-Ark., asked his Republican colleagues.

But Rep. Phil Gingrey, R-Ga., said attempts to portray insurers as gouging doctors and hospitals were illogical. He said 15 of Georgia's 20 largest insurance companies have stopped issuing medical malpractice insurance, showing that the business was hardly profitable.

"This fact flies in the face of the argument from the other side that suggests greedy insurers are just overcharging doctors for their insurance coverage," Gingrey said. "And without this insurance coverage, emergency medicine specialists, neurosurgeons, ob-gyn physicians, they're being chased out of their profession, leaving ordinary people without their specialty doctor."

Rep. Dave Weldon (search), R-Fla., who practiced internal medicine, said part of the rise in health care costs can be traced to excessive lawsuits.

"The real issue here is the incredible, incredible cost of defensive medicine. I practiced it every day," Weldon said. "I confess. I ordered extra tests to keep myself from being sued."

Despite the $250,000 cap on pain and suffering, victims of medical malpractice could end up getting much more. The legislation says punitive damages, aimed at punishing the medical provider, could total twice the amount of economic damages awarded. For example, if somebody received $1 million for lost wages and medical bills, he could conceivably get up to $2 million in punitive damages.

The Bush administration applauded the House vote.

"We must put in place a common-sense system that ensures injured patients receive fair and prompt compensation without threatening access to quality care for all other Americans," said Health and Human Services Secretary Mike Leavitt. "This legislation moves us in the right direction to address this problem."