UnityPoint Health-Des Moines is going to court to try to block the creation of two new cardiac catheterization labs. (Photo by Sean Gallup/Getty Images)
Representatives of Iowa’s medical community blamed soaring awards in medical malpractice cases for the erosion of health-care access in rural Iowa Monday. They were arguing for legislation to put a $250,000 cap on noneconomic damages in lawsuits that arise from medical errors.
But lawyers who litigate medical malpractice cases say claims against insurance carriers are low in Iowa and the legislation would make it impossible for injured Iowans to even try their case.
The two Republicans on a Senate subcommittee advanced Senate Study Bill 3150. Current law limits noneconomic damages such as pain and suffering or loss of consortium to $250,000 unless the jury finds there is a substantial or permanent loss or impairment of a bodily function; substantial disfigurement; or death.
The legislation would eliminate a jury’s ability to award more than $250,000 for noneconomic damages, regardless of the severity of the injury.
Dr. Tiffani Milless of Iowa Pathology Associates said she has seen her medical malpractice premiums increase and she has had to increase her insurance coverage because of a legal climate that results in high awards. She said her main concern was the effect on access to care and the ability to recruit physicians in rural Iowa.
“You can never repay someone financially for a life but the worst thing is that then we change the access to care for our whole state, we bankrupt our state, we take away access to care for all the other babies, children and people in the future that need access to caring doctors and nurses,” Milless said.
Matt McKinney, lobbyist for the Iowa Health Access Coalition, said the size of awards in Iowa cases has nearly doubled in the past four years. The result, he said, is physicians not offering high-risk procedures or seeing high-risk patients — or relocating to other states. “Those very large damages are having a very large impact on our health-care community,” he said.
He said the year before Missouri enacted a hard cap on noneconomic damages in malpractice lawsuits, the state lost 225 physicians. The year after that state limited damages, he said, 486 physicians located there.
Missouri’s legislation capped noneconomic damages at $350,000 — until the state supreme court ruled in 2012 that the law unconstitutionally denied plaintiffs the right to a jury trial, according to the St. Louis Post-Dispatch. Since 2015, Missouri has limited noneconomic damages to $350,000, but provides a higher, $700,000 limit for catastrophic injuries.
Lawyers who opposed the bill also raised the concern about whether injured Iowans would have access to the courthouse under the legislation. “No Iowa citizen under this proposed change would be entitled to have her case tried by a jury, have damages assessed by a jury if the jury (award) exceeded $250,000. I find that unconscionable,” said Timm Reid, a Runnells attorney who spoke representing Iowa Association for Justice.
Attorneys who spoke to the subcommittee said medical malpractice cases cost more than $200,000 to try, so few plaintiffs would be able to take a case to court. “A $250,000 cap would basically do away with malpractice (cases),” attorney Russ Hixson of Des Moines said. “… Nobody would take these cases. You cannot afford to take them.”
There’s a large difference between the amount of a large jury award announced at trial and the amount actually paid to plaintiffs, the lawyers said.
Reid said the cost of malpractice insurance in Iowa has not increased over the past 10 years. During that time, he said, the medical liability insurance industry has collected over $700 million in premiums from Iowa medical professionals and paid out just over $300 million in combined losses and expenses.
Sen. Zach Whiting, R-Spirit Lake, chair of the subcommittee, said he was willing to move the bill forward for more discussion. But he indicated he has some reservations. “I don’t know if $250,000 is the right number,” he said. “Maybe there’s a different number that’s more just. Maybe we have best practices from other states that do this.”
The bill moves to the Senate Judiciary Committee, which will have to approve it by the end of this week under the Legislature’s “funnel” deadline for policy bills.
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