SPRINGFIELD (AP) - Lawmakers have signed off on a medical malpractice reform plan that caps the high lawsuit awards doctors blame for driving up their insurance costs and driving their colleagues out of the state, but the fight is far from over.

The limits on noneconomic damages that victims can win in court created an uproar in the legislature as lawmakers debated the measure into the early hours Tuesday.

The House eventually approved the reform package 68-46, and the Senate voted 36-22, sending it to the governor. Gov. Rod Blagojevich says he personally opposes caps, but he pledged to sign it.

Both sides expect the caps will quickly be challenged in court.

The Illinois Supreme Court has twice rejected caps, most recently in 1997 as part of a broader lawsuit reform law that covered wrongful death and personal injury cases. The court said the law was illegal special legislation and that lawmakers acted arbitrarily and infringed on the judiciary's power to reduce unfair damage awards.

Doctors, hospitals and some Republicans say the reform package approved Tuesday addresses the constitutional concerns raised in other court cases. It limits the caps to medical malpractice cases, and it stresses through a set of legislative findings the public policy value of caps in preserving patients' health care options.

The plan caps noneconomic damages, such as for pain and suffering, at $500,000 in cases against doctors and $1 million against hospitals. Economic damages, such as medical expenses and lost wages, would not be affected.

The caps aren't as low as supporters wanted, but they say they're confident the limits will help lower rates and improve access to health care by keeping more doctors from leaving Illinois. The measure also gives state regulators more power to review and change malpractice rates, investigate complaints and punish bad doctors.

"It hurts a little bit of everybody, but it helps by keeping good doctors here in Illinois," said Rep. Randall Hultgren, R-Wheaton.

Trial lawyers, victims' groups and some Democrats argue that the caps unfairly punish victims for doctors' bad behavior and insurers' poor business practices to gain political cover.

"Rates now are artificially high and should be reduced," said Kevin Conway, president of the Illinois Trial Lawyers Association. "It's the patients who are having their rights stripped away."

State officials say there is no definitive data on how many doctors have left Illinois. Two new studies appearing in today's Journal of the American Medical Association question the impact of medical malpractice reforms.

One found that from 1985 to 2001 the supply of doctors increased by about 3 percent more in states with reforms such as malpractice award caps, but it found little evidence that doctors were leaving their states for others with more favorable liability climates.

The other study found more doctors were avoiding riskier procedures for fear of lawsuits, which could decrease accessibility to some types of health care. Dr. William Sage, a Columbia University law professor and co-author of both studies, said the practice is probably widespread, especially in states "with unstable malpractice environments."

Supporters of capping medical malpractice awards say they can't promise the new caps will significantly lower insurance rates.

"I don't know that there are any guarantees, but I believe it will (work)," said Rep. Dan Reitz, D-Steeleville. "It's about the greater good for the people of the state of Illinois."

Both sides have been preparing for a court fight. The issue of medical malpractice played a major role last fall in electing a Republican to the state Supreme Court in a Democrat-controlled Southern Illinois district. The candidates, financed largely by trial lawyers on the Democrat's side and doctors and business groups on the Republican's, spent a combined $9.3 million, making it the most expensive judicial race in U.S. history.