Important California Ballot Initiative: Learn Why Medical Injury Compensation Reform Act (“MICRA”) Must be Preserved

Important California Ballot Initiative: Learn Why Medical Injury Compensation Reform Act (“MICRA”) Must be Preserved

Important California Ballot Initiative: Learn Why Medical Injury Compensation Reform Act (“MICRA”) Must be Preserved

By Steve Wehn, Vice President, NATHO 
and Vice President, AMN 
Government and Community Relations

Executive summary on why to oppose this ballot initiative:

  • Trial lawyers drafted a November 2014 California ballot measure seeking to change current law to file more medical lawsuits against health care providers and causing payouts to skyrocket. Someone will have to pay those costs. And that someone…is us.
  • Money isn’t the only thing this ballot measure will cost you. It could cost you your personal privacy, and the doctors we trust and depend on.
  • If California’s medical liability cap goes up, many doctors will choose to not come or leave California to practice in states where medical liability insurance is more affordable.
  • Join a diverse and growing coalition of trusted doctors, community health clinics, hospitals, local leaders, public safety officials, and businesses. To learn more about this ballot initiative and join, go to

Additional information:

In my role at AMN Healthcare, I continually monitor the regulatory environment for any issues or legislation that may impact our business, clients, clinicians and/or physicians. An important matter has come before us that I want to bring to your attention if you are not already aware. Especially if you currently do business or plan to do business in California. Last month it was announced that the anti-MICRA ballot measure had officially qualified for the November 2014 California ballot.

A broad and bipartisan coalition of doctors, community health centers, hospitals, local governments, public safety, business and labor unions has formed to fight this November 2014 ballot proposition drafted by trial lawyers out to profit from medical lawsuits. If passed, this ballot measure will increase health care costs, threaten the privacy of personal prescription drug information, and will jeopardize people’s ability to see their trusted doctors.

The measure’s main provision will quadruple the non-economic damages cap on California’s successful Medical Injury Compensation Reform Act (MICRA), the law that governs legal proceedings if someone is injured in a medical procedure. This single change will triple trial lawyers’ legal fees in the non-economic damages portion of medical lawsuits filed against doctors and hospitals.  (Note: Under MICRA, economic damages for past and future lost wages, past and future medical costs, and punitive damages are unlimited.) If trial lawyers get their way, medical lawsuits and payouts will skyrocket.  Someone will have to pay those costs.  And that someone includes providers, consumers, businesses and taxpayers.

The measure contains two other unrelated provisions dealing with drug testing and prescription drug databases which were intentionally included by the backers in an attempt to mislead voters by taking the focus off the lawsuit provisions. The prescription drug database poses serious privacy risks for California patients. And the drug testing provision was included for political, not policy reasons. In fact, one of the main supporters of the proposition admitted to the Los Angeles Times that the drug rules are in the initiative because they poll well, calling these provisions “the ultimate sweetener.”

Here’s more information why the MICRA ballot measure should be defeated: 

Costly for Consumers

According to a study by California’s former Legislative Analyst, the new lawsuits and massive payouts under this proposition will increase health care costs across all sectors by $9.9 billion annually. That amounts to more than $1,000 a year in higher health costs for the average California family. And California’s current independent Legislative Analyst’s Office (LAO) warns the proposition could increase state and local government medical liability and health care costs by “hundreds of millions of dollars annually,” placing the burden of this additional cost on all taxpayers.

Threatens People’s Personal Privacy

This measure forces doctors and pharmacists to use a massive statewide database filled with Californians’ personal medical prescription information.  A mandate government will find impossible to implement, and a database with no increased security standards to protect people’s personal prescription information from hacking and theft – none

Jeopardizes People’s Access to their Trusted Doctors

If California’s medical liability cap goes up, people could lose access to their trusted doctors. .  Many doctors will be forced to leave California to practice in states where medical liability insurance is more affordable. Respected community clinics, warn that specialists like OB-GYNs will have no choice but to reduce or eliminate vital services, especially for women and families in underserved areas.

Additional Problems for Physicians

California’s Controlled Substance Utilization Review and Evaluation System (“CURES”) Database Problems Could Jeopardize Patient Access to Needed Medications

The new mandate that providers check CURES before prescribing or dispensing Schedule II or III controlled substances takes effect the day after the November 2014 election – an impossible implementation timeline given the current state of CURES which today lacks important functionality. Without an upgraded CURES database, prescribing health care providers and pharmacists would be legally required to use a database that has, in practice, not been available. According to a recent review of the CURES database and the provisions in the ballot measure, “providers would face the choice of denying treatment to their patients or violating the stated terms of the initiative.

Provisions Impose a Presumption of Professional Negligence

This ballot measure also flips on its head “innocent until proven guilty,” and instead institutes a presumption of professional negligence in any action against a health care provider arising from:  

  • an act or omission by a physician or surgeon who tested positive for drugs or alcohol;
  • an act or omission by a physician or surgeon who refused or failed to take a test for drugs or alcohol; and
  • the failure of a health care practitioner to comply with the mandatory CURES rules

You can also reach out to me directly at with any questions you may have.