Pennsylvania doctors can expect to pay higher malpractice insurance bills soon.

House Democrats yesterday turned back attempts by Republican members to win approval for a one-year extension of financial assistance for doctors to defray malpractice insurance costs, known as the MCare abatement program. But even if GOP members had succeeded, Gov. Ed Rendell likely would not have signed the bill.

Dr. Peter Lund, an Erie urologist and president of the Pennsylvania Medical Society, said the group had informed doctors to prepare to pay more.

In Allegheny County, the higher amounts range from about $1,250 for family physicians to nearly $13,000 for general surgeons, more than $14,000 for obstetricians and more than $18,000 for neurosurgeons.

"I think most physicians are very hopeful that something will eventually be worked out between Democrats and Republicans," Dr. Lund said.

A legislative standoff continued yesterday over a proposal to help doctors defray their malpractice insurance costs and extend affordable health care coverage to the state's uninsured adults.

Though he favors a 10-year extension to the abatement program, the Democratic governor has said he will not approve an extension unless lawmakers show progress toward making more affordable coverage available to the uninsured.

Dr. Lund said the medical society supports major provisions in the House Democrats' bill, including the 10-year extension of the abatements; a planned phaseout of the abatements and the MCare program, a state insurance program that provides doctors with catastrophic coverage for medical malpractice; and retirement of MCare's $2 billion unfunded liability, or cost of future claims.

It also supports provisions to extend affordable coverage to the uninsured.

"We know people who are uninsured are less healthy and die sooner. We have a moral obligation to fix that," Dr. Lund said.

Still, the group has some concerns about the House Democrats' bill, he said, including payment rates that remain unclear and a provision that doctors who accept abatements be required to care for adult patients through the proposed program, Pennsylvania Access to Basic Care, and an existing program for children known as Cover All Kids.

The medical society also regrets that the state's doctors have been placed in the middle of the political controversy, he said.

Senate Republicans could act on the House bill, but GOP leaders have expressed concerns about the cost of the Access to Basic Care program and the fact that Democrats have not identified funding sources for about $120 million needed each year. They also don't believe that program and the MCare extension should be considered together.

By their actions yesterday, Democratic leaders "made the decision to kill the MCare abatement for the time being," said Steve Miskin, spokesman for House Republican leader Sam Smith of Punxsutawney.

"We feel strongly that this course is the right course," said Rep. Todd Eachus, a Luzerne County Democrat and chief sponsor of the House bill. He said Democrats want to help both the state's doctors and the uninsured.