JEFFERSON CITY, Mo. (AP) — The Missouri Senate gave initial approval Tuesday to a measure reinstating limits on noneconomic damages in medical malpractice cases three years after lower caps were overturned by the Missouri Supreme Court.

The Senate compromise between Democratic and Republican lawmakers provides different limits for different levels of injury and raises an existing cap when a patient dies from medical malpractice. Supporters of caps have sounded the alarm since the state's highest court ruled the $350,000 limit passed in 2005 was unconstitutional.

They say the lack of limits could increase insurance costs for doctors and drive them out of the state, leading to less access to care and higher health care costs to consumers. Bill sponsor Sen. Dan Brown, R-Rolla, said he was not completely happy with the compromise but wanted to move forward anyway.

"We had an opportunity to put some certainty in the marketplace so doctors and actuaries can put a number on it. Right now it's open-ended," Brown said.

In most cases, a cap of $400,000 would apply. In more serious "catastrophic" injuries specifically defined in the bill — including paralysis, brain injury or a loss of vision — the cap would be $700,000. The bill also raises an existing $350,000 cap on noneconomic damages in wrongful death cases to $700,000.

All three of these caps would increase each year by 1.7 percent under the bill.

The limits apply only to noneconomic damages and would not apply to other damages such as lost wages or medical costs resulting from negligence by a health care worker. Opponents have previously said caps harm patients who have already been injured by the actions of a doctor, limiting their ability to get restitution.

In the past, opposition from Senate Democrats has blocked efforts to reinstate caps. The higher caps, tiered system and increased limits in death cases caused Democrats to allow the bill to come to a vote.

Sen. Scott Sifton, D-St. Louis County, said he supported the compromise and that there should be some certainty for victims, health care providers and insurers in medical malpractice cases. However, he said limits would still negatively affect some people.

"There will be situations where frankly people will not be adequately compensated for their noneconomic damages," Sifton said.

The measure passed by a voice vote and must get final approval before moving to the House, where a measure for a flat $350,000 limit on noneconomic damages in medical malpractice cases was passed last week.

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The bill is SB 239.

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Online

Senate: http://www.senate.mo.gov

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Follow Marie French on Twitter at https://twitter.com/m_jfrench.