MICRA: California's Cap for Medical Malpractice

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In 1975, physicians in California were faced with skyrocketing insurance rates, because of an increase in medical malpractice lawsuits.  Some had to stop their practice, because they could not find insurance that would cover them.  Higher insurance rates were being passed on to consumers in the form of increased healthcare costs.  In response, there was an effort to “reform” tort law (tort law concerns lawsuits about someone’s negligence or carelessness), and reduce plaintiff’s lawyers’ fees. 

The result was the California Medical Injury Compensation Reform Act (MICRA) of 1975.  At California Civil Code Section 3333.2, MICRA caps “general damages” for pain and suffering, emotional distress, and loss of companionship, at $250,000.  “Special” or “economic” damages, such as lost wages, extra costs, and repair or replacement, remain unlimited. 

MICRA requires that the action be against a “health care provider” based on “professional negligence.”  A health care provider is essentially someone with a license, and professional negligence points to the carelessness of a professionally licensed person, which is a higher standard of care than ordinary negligence.  This means that in a “slip and fall” case, such as when a hospital patient slips on a puddle of liquid soap left by a janitor, patients can recover unlimited general damages.  The same theory applies to the hospital’s failure to supply adequate security, equipment, personnel, or facilities in cases where one patient injures another. 

As MICRA has been around for more than 30 years, experts have been able to evaluate its effectiveness in lowering insurance rates and the cost of health care in general.  It has been called a “model” for the nation. 

However, there is some disagreement over whether MICRA has been effective.  Medical journals have generally praised MICRA for lowering doctors’ insurance rates.  However, some law professors have criticized it as being sluggish or ineffective in actually lowering health costs.  There are also many stories of children who have been, for example, blinded by a doctor’s negligence, where the pain and suffering over a lifetime is arguably more than $250,000. 

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Last Modified: 06-30-2009 01:51 PM PDT

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