Senate Republicans moved yesterday to force debate on legislation to put stringent limits on medical malpractice awards, even though Democrats appeared ready -- and able -- to block action on the measure.

A showdown vote on an expected Democratic filibuster against the legislation was scheduled for Wednesday after Democrats objected to a procedural move to bring up the bill immediately for debate and votes.

Republicans have conceded they lack the 60 votes needed to limit debate in the 100-member chamber, but say they see the vote as a first step toward eventual passage or, failing that, as an issue for next year's elections. Democrats plan to decide today whether to filibuster the bill. Aides said yesterday a filibuster was likely.

The GOP bill, sponsored by Sen. John Ensign (R-Nev.), includes elements of President Bush's initiative to cut down on huge damages awards in lawsuits and is similar to legislation the House approved earlier this year. It would cap awards for pain and suffering at $250,000 and limit lawyers' fees. It would also limit punitive damages to twice the award for economic losses or $250,000, whichever was greater.

Republicans say soaring malpractice awards are inflating the cost of doctors' insurance and driving many physicians to abandon their practices, in some cases leaving patients without access to needed care. Democrats blame insurance companies for the rate increases and say the GOP bill would wind up harming malpractice victims without addressing problems generated by the insurance industry.

The debate pits insurers, businesses and physicians -- many of whom contribute to Republican campaigns -- against trial lawyers, who are key supporters of Democratic campaigns. Among the bill's most ardent supporters is Majority Leader Bill Frist (R-Tenn.), the Senate's physician.

"Our current medical liability system encourages excessive litigation, drives up costs and is literally scaring doctors out of the medical profession," said Sen. Mitch McConnell (R-Ky.), the majority whip. "All too often these lawsuits result in exorbitant judgments that benefit personal injury lawyers more than they compensate injured patients."

Sen. Richard J. Durbin (D-Ill.), a leading foe of the bill, described the measure as "fundamentally unfair . . . as unfair to victims as the malpractice insurance rates are to doctors." He criticized Republicans for trying to force a vote on the bill without going through the normal committee process, including public hearings. "They don't want people of this country to hear both sides of the story," he said.

Durbin's office said he and Sen. Lindsey Graham (R-S.C.) plan to introduce an alternative today that would also deal with what the office described as "anti-competitive behavior by insurance companies" and other factors not addressed by the GOP measure.