A medical malpractice bill that limits attorney fees and some patient damage fees in civil lawsuits was passed by the House on Wednesday by a narrow margin of 218 to 210, with numerous Republicans voting against the measure. The biggest point of contention was over a provision that places a cap of $250,000 on noneconomic damages awards to victims, which includes pain and suffering. Nineteen Republicans voted against the bill, many of them citing this as a key reason, saying it would trample on states’ rights because it would take away their ability to establish their own laws on the matter.