California Voters May Revisit Medical Malpractice Damages Cap

This fall California voters may face a ballot initiative to revise a nearly 40-year-old law that caps medical malpractice damages.  If initiative proponents obtain enough signatures to put the measure on the November ballot, the battle for votes is likely to cost millions and result in massive no-holds-barred advertising campaigns from both supporters and opponents.

The initiative effort is just the latest battle in California’s war over medical malpractice damages limits.  A 1975 California medical malpractice law known as the Medical Injury Compensation Reform Act (MICRA) provides that malpractice victims can recover a maximum of $250,000 in compensation for pain and suffering caused by the wrongful treatment.  The initiative would adjust the cap to account for inflation, increasing it to roughly $1.1 million in 2015, and link the cap to the inflation rate in the future.

Cap on medical malpractice damages opposed by consumer groups

Consumer groups and trial lawyers have long opposed the damages cap.  They charge that, even after a jury has found a doctor’s negligence caused a patient serious injury or even death, the damages limit forces the victim of that negligence to suffer physical and emotional pain without adequate compensation.  In addition, by limiting doctors’ liability for medical mistakes or negligence, the damages cap fails to offer sufficient incentive for doctors to provide high-quality care.

Thus, according to opponents, the damages limit both imposes unwarranted harm on malpractice victims and fails to deter physician negligence.

Physician associations and insurance companies, on the other hand, claim that the 1975 damages cap was necessary to rein in skyrocketing malpractice insurance premiums that were making it too expensive for doctors to practice in California.  Doctors and insurers argued that limiting damages for pain and suffering would help keep premiums affordable and prevent doctors from fleeing the state to practice elsewhere.

The rationale for the cap remains the same today, contend its supporters, particularly in light of what may be increasing medical costs associated with the Affordable Care Act.

Opponents of the 1975 law repeatedly sought to amend the statute, but those efforts went nowhere in the California legislature.  Court challenges to the cap met a similar fate, as the California Court of Appeals and California Supreme Court rejected opponents’ claims.

Now malpractice damages cap adversaries are taking their case to the voters.  And, in an apparent effort to win more widespread support for their cause, the initiative’s backers have expanded the reach of their proposal to encompass substance abuse issues.

The proposed initiative includes provisions requiring drug and alcohol tests for doctors and suspension of medical licenses pending an investigation for those who fail the tests.  The measure also requires doctors to consult a statewide database before prescribing narcotics to a patient, “in order to protect patients and others.”

Potential changes in California medical malpractice law

Doctors and insurance companies have likewise sought to broaden support for the existing medical malpractice cap.  According to the Los Angeles Times, medical associations and coalitions of insurers have reached out to Planned Parenthood and community clinics, evidently in order to rally pro-choice and low-income women’s advocates to what has traditionally been portrayed as a pro-big business, anti-consumer measure.  Labor unions, too, presumably those who represent workers in hospitals and health care facilities, have reportedly been approached for their support.

An umbrella advocacy group called Californians Allied for Patient Protection (CAPP) is also supporting the $250,000 medical malpractice damages cap.  According to CAPP’s website, the organization is dedicated to “protect[ing] access to health care and patient safety through California’s landmark Medical Injury Compensation Reform Act (MICRA).”  CAPP’s website identifies its supporters as “physicians, dentists, hospitals, community clinics, health centers, nurses, emergency providers, police officers, local governments, labor unions, women’s health advocates and other health care professionals.”

According to California contribution records, CAPP had nearly $225,000 in cash on hand as of December 31, 2013.  The vast majority of that sum was contributed by insurance companies, national and California-based doctors’ and dentists’ associations, and a pharmaceutical company headquartered in Indiana.

In order to get the proposal on the November ballot, backers of the initiative must obtain signatures from 504,000 California voters by March 24.  Supporters and opponents of the damages cap, both in California and across the country, will be watching closely as the situation develops.