WASHINGTON (Legal Newsline)-The U.S. House of Representatives on Saturday passed a landmark health care overhaul that changes the way the nation's medical insurance companies do business.

But critics say one critical component to keeping costs down -- tort reform -- is noticeably absent from the White House-backed plan.

"Any physician in America will tell you that the simplest way to reduce health care costs is to enact real medical liability reform," said House Minority Whip Eric Cantor, R-Va. "The fear of being sued by opportunistic trial lawyers is pervasive in the practice of medicine. Our system wastes billions on defensive medicine that should be going to patient care."

The $1 trillion House bill, which narrowly passed on a 220-215 vote, had the support of one Republican -- first term Anh "Joseph" Cao of Louisiana -- and opposition from 39 Democrats.

The House bill would bar insurers from denying coverage and prohibit the insurance industry from charging higher premiums to consumers with a preexisting condition.

There are far-reaching changes included in the House-approved bill, which was nearly derailed in a battle over abortion funding.

The bill contains a public insurance option, which proponents say is aimed at injecting more competition into the health insurance marketplace. Under the legislation, the insurance industry would lose its exemption from federal antitrust restrictions on market allocation and price fixing.

Republican Rep. Mike Pence of Indiana on Sunday blasted Saturday's vote.

"Last night, on a narrow, partisan vote, the Democrats put their liberal, big-government agenda ahead of the American people," Pence said in an appearance on the "Fox News Sunday" program.

The House-approved 2,000- page plan and the one that is expected to be passed in the Senate will be merged in conference committee before a final bill goes to President Barack Obama, who has made health care reform his No. 1 domestic priority.

Among other legal reforms, House Republicans had suggested a cap on punitive damages and narrowing the statute of limitations on malpractice claims would reduce health care costs.

The director of the nonpartisan Congressional Budget Office, Douglas Elmendorf, has said as much as $54 billion could be saved over the next 10 years if Congress enacts legal reforms including a $250,000 cap on damages for pain and suffering and a $500,000 cap on punitive damages and restricting the statute of limitations on malpractice claims.

The House plan would, according to the nonpartisan Congressional Budget Office, extend insurance coverage to 36 million uninsured Americans and see to it that about 96 percent of Americans have medical coverage.

"This legislation will mean affordability for the middle-class, security for our seniors, and honors our responsibility to our children, adding not one dime to the deficit," said House Speaker Nancy Pelosi, D-Calif.

To pay for the coverage expansion, House Democrats want a surtax on couples who make more than $1 million a year, and a 2.5 percent excise tax on medical devices.

In the Senate, Majority Leader Harry Reid, D-Nev., is having trouble gathering the 60 votes needed to approve a plan.

"The House bill is dead on arrival in the Senate," Sen. Lindsey Graham, R-S.C., said Sunday on CBS's "Face the Nation. He decried the bill as one "written by liberals for liberals."

If signed by Obama, the health care overhaul would mark the most significant expansion of medical care since Congress created Medicare in 1965 for the nation's elderly.

From Legal Newsline: Reach staff reporter Chris Rizo at chrisrizo@legalnewsline.com.