This week, Consumer Watchdog, an offshoot of the Consumer Attorneys of California, submitted signatures in an attempt to get an anti-MICRA proposition on the November ballot. If news reports are accurate, the measure will likely qualify. Final certification is expected mid-May.
The measure has significant implications for local governments concerned about the cost of health care and access to doctors, community clinics and hospitals. The main provision of the lawyers’ ballot measure will quadruple MICRA’s non-economic damages cap from $250,000 to nearly $1.1 million.
The Medical Injury Compensation Reform Act (MICRA) was signed into law by former and current Governor Jerry Brown in 1975 in an effort to curtail runaway non-economic damages in medical malpractice cases. Medical malpractice insurance was becoming prohibitively expensive and difficult to obtain in California, especially for certain specialties such as obstetrics. This in turn was driving physicians in numerous specialties out of California, making access to those services difficult, if not completely unavailable in many parts of the state—especially rural areas.
MICRA caps any non-economic damages award at $250,000. There remains no limit on awards for actual damages, including costs of ongoing care, loss of income, or punitive damages under MICRA.
According to California’s independent Legislative Analyst’s Office (LAO), the proposition would increase state and local government health care costs by “hundreds of millions of dollars annually.” The LAO additionally comments that “even a small percentage change in health care costs could have a significant effect on government health care spending.” This is relevant to counties in that these costs would need to be passed along to employees, borne by the county General Fund, or benefits would have to be reduced to as the result of a change to the cap. The LAO report can be accessed here.
Perhaps the more threatening outcome of altering MICRA is one that will be felt much more keenly in rural areas. Increasing costs to local providers, community clinics, and local hospitals could force them to reduce services or cease providing services altogether. In rural areas, limited access to healthcare – especially specialty services – is already a serious problem, and a change to MICRA would exacerbate this situation dramatically.
In addition to the ballot measure, there was an effort by Senate President Pro Tem Darrell Steinberg in SB 1429 to find a legislative compromise on the issue of MICRA, before the ballot initiative was finalized. At this point, however, it appears that he is no longer pursuing that effort.
A broad coalition of doctors, hospitals, community health clinics, local governments, nurses, business, labor and others, including RCRC, have long supported the existing MICRA law as a protector of access to care.
For additional information, please contact RCRC Legislative Advocate Cyndi Hillery at 916.447.4806 or chillery@rcrcnet.org.