Lawmakers OK limits on malpractice awards

DES MOINES — Cash awards for pain, suffering and other non-economic complications from medical malpractice lawsuits would be capped at $2 million for hospitals and $1 million for doctors under a measure that soon will be state law.

Republican state lawmakers approved the proposal Wednesday, and Gov. Kim Reynolds has signaled she will sign it into law.

The proposal will cap non-economic damages in medical malpractice cases; it does not cap economic or punitive damages.

Supporters of the caps argue they are needed so hospitals and other health care centers can avoid fiscal chaos caused by high-dollar jury awards and insurance.

Opponents say the caps limit the ability of victims and their families to fully obtain justice. And they argue large verdicts are not a problem in Iowa, as very few medical malpractice lawsuits go to trial in the state.

According to a fiscal note accompanying the bill, about 160 medical malpractice lawsuits were filed each year since 2017, of which only 8 percent went to trial.

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 that do have the limits cap non-economic damages ranging 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. Minnesota and Illinois do not.

Representatives of the medical community have pointed in particular to two judgments from 2022 in Iowa: a $97.4 million award to a family whose newborn suffered 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.

Both chambers of the Iowa Legislature spent hours debating the proposal Wednesday. The legislation, House File 161, passed the Senate by a 29-20 vote and the House by a 54-46 vote. It was supported almost exclusively by Republicans: Rep. Ken Croken, from Davenport, was the only Democratic legislator in either chamber to vote in favor of the bill.

Not all Republicans supported the measure, however: five Republicans in the Senate and 11 in the House voted against it.

Republicans who opposed measure said it puts a value on life, which they said is contrary to Republicans’ “pro-life” positions. Rep. Mark Cisneros, a Republican from Muscatine, slammed his party’s leadership for prioritizing the bill.

“Will you seriously allow yourselves to be bullied into bending your moral compass away from the people of Iowa and point it directly toward the billion-dollar corporations who want this handout?” he asked. “Contrary to popular belief, you can say no to leadership.”

Rep. Ann Meyer, a Republican from Fort Dodge who led the bill in the House, she said she lost a son because of a medical error when he was 5 years old.

“I was very angry at that time as well,” she said. “No amount of money will bring Nick back, and I feel that loss every single day.”

But, she said, the bill is necessary to improve the offering of health care in the state and attract doctors. It is one of many bills the Legislature is considering to enhance medical care, she said.

“I'm trying to keep the health system intact for all of Iowa, from one corner of the state to the next,” she said. “For 3.2 million Iowans that depend on us to look at the entire health care system and make sure they have access to care.”

However, opponents noted that other states with medical malpractice caps are also struggling to find enough doctors. They said insurance reimbursement rates are a far more pressing issue.

“I look forward to your work to increase provider reimbursement rates,” Sen. Zach Wahls, of Coralville, the leader of the minority-party Senate Democrats. “I’m not holding my breath.”

Sen. Jason Schultz, a Republican from Schleswig who managed the legislation in the Senate, indicated another part of the motivation was to rein in money made by lawyers involved in those cases.

“Nobody wants to be there (in a medical malpractice lawsuit) except the guy getting a third,” Schultz said during Senate debate, referring to lawyers who receive shares of jury awards. “Folks, we’re being poached. It’s got to be fixed.”

Reynolds highlighted the idea of capping awards in her annual Condition of the State address earlier this month.

“I’m grateful to the Legislature for passing reasonable medical malpractice reform, allowing Iowa’s health care industry to become stronger and more accessible,” she said in a statement after the vote. “To the OBGYNs and physicians who have been worried about practicing in Iowa, we are ready for you! These reforms balance the needs of injured patients with the needs of all Iowans to have a robust health care system. As I said in my Condition of the State, these reforms could not wait another year.”

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