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$1 million cap on medical malpractice awards being considered in Iowa
Medical officials say without a cap, Iowa will have a difficult time keeping physicians; opponents say it puts a price tag on a wronged person’s well-being

Jan. 25, 2023 4:42 pm, Updated: Jan. 26, 2023 9:32 am
A close-up view shows intricate details on the Iowa Capitol in Des Moines on Dec. 19, 2019. (The Gazette)
DES MOINES — Cash awards for pain, suffering and other non-economic complications from medical malpractice lawsuits would be capped at $1 million under legislation being considered by state lawmakers.
The proposal has been floating around the Iowa Capitol for multiple years. But this year, Gov. Kim Reynolds highlighted the proposal in her annual Condition of the State address earlier this month.
“This is the year that we must enact common-sense tort reform to stop the out-of-control verdicts that are driving our OB-GYN clinics out of business and medical school graduates out of state,” Reynolds said during that address. “One hospital administrator said that it’s gotten so bad, he’s often asked about Iowa’s large jury verdicts during recruiting trips. Two years ago, that had never happened. The legal environment is changing, and our laws need to keep up.”
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Iowa is one of 22 states that does not have a cap on non-economic damages in medical malpractice states, according to a 2020 report from New York Law School’s Center for Justice and Democracy.
Other states’ caps on non-economic damages range between $250,000 and roughly $800,000.
Of the states that share a border with Iowa, Wisconsin, South Dakota, Nebraska and Missouri have caps on non-economic damages in medical malpractice cases, while Minnesota and Illinois do not.
The proposed legislation in Iowa would cap non-economic damages at $1 million, but would not cap economic damages.
A legislative hearing on the proposal Wednesday at the Iowa Capitol drew much attention from statehouse lobbyists and advocacy groups.
Speakers representing the medical community said the legislation is needed because without the cap, physicians are hesitant to work in Iowa and it becomes difficult for hospitals and clinics to recruit and retain doctors. And they said without a cap, the cost of insurance can rise high enough to drive hospitals or clinics to close, especially smaller ones in rural areas.
Representatives of the medical community pointed in particular to two judgments from 2022: a $97.4 million award to a family whose newborn suffered permanent brain damage when its head was crushed due to health care providers using improper procedures during delivery, and a $27 million award to a man whose case of bacterial meningitis was misdiagnosed as the flu.
“(Physicians) don’t want to come into a state where liability is so volatile,” said Sandra Conlin, a lobbyist for the Iowa Hospital Association.
Mikayla Brockmeyer, a third-year medical student at Des Moines University, said many of her classmates, even those who are Iowa natives, tell her they would like to remain in the state and practice, but plan to leave Iowa upon graduation.
Just 22 percent of undergraduate-level medical school graduates remained in Iowa in 2020, which was the seventh-worst rate in the country, according to the most recent annual report from the Association of American Medical Colleges.
“This is something to retain the physicians of Iowa for years and years to come,” Brockmeyer said during the legislative hearing.
Those opposed to the legislation largely represented lawyers and advocacy groups. They argued the state should not put an arbitrary limit on financial rewards to Iowans who are severely injured during medical procedures.
The speakers who oppose the bill included Sam Clovis, a former Republican candidate for U.S. Senate who has filed a lawsuit that claims medical negligence resulted in his becoming paralyzed from the chest down and confined to a wheelchair, and Chip Baltimore, a lawyer, lobbyist and former Republican state lawmaker who chaired the House’s Judiciary Committee.
Tom Slater, a lawyer from West Des Moines who specializes in medical malpractice and personal injury, said he views the proposal as further whittling away patients’ rights.
“I’ve heard a lot of talk in here on the other side about doctors and hospitals and costs of insurance, system costs … Where’s the talk in favor of the patient?” Slater said. “(The bill) puts the finishing touches on not just curtailing patients’ rights, but eliminating them.”
The two Republicans on a three-person legislative panel, Sens. Jason Schultz of Schleswig and Michael Bousselot of Ankeny, moved to advance the bill, Senate Study Bill 1063, and later Wednesday it passed through the full Senate Judiciary Committee.
Sen. Nate Boulton, a Democrat from Des Moines and a lawyer, declined to sign off on the bill in the subcommittee.
Comments: (515) 355-1300, erin.murphy@thegazette.com