A bill passed by a Republican-controlled House and sought by a Republican president would normally have a pretty good chance of getting through a Republican-controlled Senate.
But little has been normal this year regarding medical malpractice legislation.
Early in the year, the outlook seemed good for federal action. Public concern with physician walkouts and President Bush's calls for legislation buoyed proponents' hopes. The House last month voted to limit noneconomic and punitive damages.
But the Jesica Santillan organ-transplant tragedy, the withdrawal of Sen. Dianne Feinstein, D-Calif., from negotiations over a compromise and the Iraq war have slowed the momentum.
Senate leaders have postponed action until May. The reasons: an inability to forge an essential bipartisan proposal and the press of war and budget issues.
"I think medical malpractice reform is in trouble right now," said Pamela Gilbert of the Center for Justice and Democracy, an opponent of malpractice legislation. "I would never say it's a dead bill. We have a leadership in the House, Senate and White House that wants it, and that is something which has never been the case in my 20-year career."
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"Public concern with legislation is the flat, one-size-fits-all $250,000 cap on damages," Gilbert said. "Most observers agree that proposal cannot pass the Senate."
[Sen. Dianne] Feinstein sought a compromise cap of $500,000 with catastrophic exceptions. She withdrew her support after the California Medical Association and other medical groups refused to support it.
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