WASHINGTON – Texas House members are mounting a late effort to delay new limits on physician-owned hospitals, putting them at odds with Democratic leaders who think the facilities drive up health care costs.

The House's health care legislation would ban new physician-owned hospitals and prevent existing ones from growing. But Rep. Sheila Jackson Lee, D-Houston, is pushing two amendments to soften the restrictions, including a grandfather clause for more than 100 doctor-owned hospitals under development.

"If you have a bill to expand care, what sense does it make to limit or close hospitals that provide very good care?" Jackson Lee asked Wednesday.

Texas has 67 physician-owned hospitals – more than any other state – with about 50 more that have yet to open, according to Rep. Sam Johnson, R-Plano.

Under the legislation, owners of new facilities couldn't refer Medicare patients to their hospitals.

That restriction "would challenge the viability" of doctor-owned hospitals that plan to open in less-affluent communities, including in big cities and the Rio Grande Valley, according to lawmakers and physicians who support the hospitals.

The restriction is championed by Rep. Pete Stark, a California Democrat who says physician-owned hospitals cherry-pick wealthy patients to the detriment of nonprofit, acute care hospitals. The American Hospital Association, a major player in health care legislation, argues that doctor-owned hospitals drive up health costs.

Rep. Eddie Bernice Johnson, D-Dallas, Sam Johnson and other Texans support Jackson Lee's effort. Sam Johnson offered a similar amendment, which wasn't accepted, when the House Ways and Means Committee considered the bill in July.

"Around 40 of our doctor-owned hospitals will effectively be shuttered," said Rep. Kevin Brady, R-The Woodlands.

But some physician-owned hospitals say the restrictions would force them to focus on wealthy patients.

Richard Toussaint, an anesthesiologist who founded Forest Park Medical Center in North Dallas, said his hospital would be barred from treating Medicare and Medicaid patients under the law. Forest Park opened in March and received its Medicare certification in August. The House bill grandfathers facilities that were certified by Medicare before Jan. 1. A Senate bill includes a similar provision.

"This would force us to only take what they define as the cream of the health care industry," said Toussaint, whose hospital has a 24-hour emergency room but focuses on surgeries. "That just seems unethical and not correct to us."

Dallas' Baylor Health Care System includes nine hospitals that have some doctor ownership, and one more that is scheduled to open next year in Arlington.

Jackson Lee said Baylor Health Care has "been a key advocate for explaining the great care they give."

Lawmakers may vote on the health care bill Saturday. It would expand coverage to about 36 million uninsured through a combination of subsidized private insurance and an expansion of Medicaid.

The House Rules Committee will decide Friday whether to accept any amendments, said Vincent Morris, a committee spokesman. But House leaders have "pretty consistently said that there is unlikely to be a lot of amendments to a bill that represents such a delicate compromise," Morris said.

Jackson Lee said she is working with about 20 other members to push the changes and spent Tuesday evening selling them to House leaders.

Her second amendment would allow some doctor-owned hospitals – ones that treat a disproportionate number of low-income patients – to expand. The lawmaker has a hospital in her district, St. Joseph Medical Center, which would be affected by the restriction.