The Republican-led House has again passed a medical liability reform bill, setting the stage for what could be a fourth rejection by their Senate counterparts. Although Republicans control the Senate, the GOP does not hold a strong enough majority to prevent Democrats from filibustering undesirable bills.

Three times already Congress Senate Democrats have thwarted attempts to bring a companion bill to a House-approved measure to a vote. The House passed HR 4280, the HEALTH Act of 2004, by a 229-197 vote largely on party lines on Wednesday.  The measure would cap noneconomic damages in healthcare lawsuits at $250,000, allow unlimited economic recoveries, and limit punitive damages to $250,000 or double the amount of economic damages awarded, whichever is greater

Senate Republican sources this week reportedly said their next attempt to pass a liability reform bill would focus on relief for providers in rural areas but also include obstetricians, gynecologists and emergency room physicians, all of whom were highlighted in previous bills.

The House-passed bill would protect the full spectrum of healthcare providers, including nursing homes, unlike more narrowly focused measures addressed by the Senate earlier this year.