Medical malpractice bill advances to House floor

Legislation capping noneconomic damages in medical malpractice cases could be headed for floor debate in both chambers of the Iowa Legislature as soon as this week.

The House Health and Human Services Committee passed House File 161 on a 12-9 vote Monday.

The Senate Judiciary Committee approved a version of the bill, Senate File 148, last week. Both versions would institute a $1 million cap on noneconomic damages against health care providers in lawsuits over medical incidents which result in the loss or impairment of a bodily function, disfigurement or death.

House lawmakers amended “loss of pregnancy” to that list, which was not included in the Senate bill. Noneconomic damages may include, for example, pain and suffering, emotional trauma, or loss of consortium of a spouse.

Rep. Ann Meyer, who chairs the House committee, said lawmakers heard in a subcommittee meeting from many trial lawyers that this legislation will hurt Iowans. But she said, as someone who has lost a family member to a medical error, no amount of money will bring someone back, but the high cost of lawsuits is putting Iowa hospitals out of business.

Meyer said “out of control” jury verdicts were closing doors of rural health care providers across the state through high liability premiums, and raising costs for patients through unnecessary testing. While she said she understood why juries award huge sums to victims in medical malpractice cases, she said the $1 million cap will help keep providers in Iowa.

“That’s what’s being taught, that facts don’t matter, emotions matter. And that jury has to look at the emotion of the family,” Meyer said. “And I completely understand that, because I’ll tell you what, when my son passed away, I was angry. I was angry. But I’m a legislator. I can’t just look at one case. None of us can look at one case, we have to look at the entire state of our health care.”

But other lawmakers disagreed that malpractice insurance costs are driving hospitals to close. Rep. Brian Lohse, R-Bondurant, said Iowa’s medical malpractice insurance rates have remained stable in recent years, and premiums are lower in Iowa than in surrounding states that have caps. Iowa ranks 10th for the lowest medical malpractice insurance cost in the country, according to the publication Physicians Practice.

Lohse also disputed claims that doctors were leaving Iowa. In 2012, Iowa had 6,400 physicians, he said. In 2020, that number grew to 7,000. While he said the Legislature still needs to take action to help support rural health care, he argued that setting a limit on damages is not the correct solution.

“It’s not our right not knowing the facts and set a limit on persons’ pain and suffering,” Lohse said. “In fact, I find it incredibly arrogant for us to sit here and say we know better than the people who hear the facts and have the right to do so.”

Lohse proposed an amendment to raise the cap to $5 million, which was voted down.

Rep. Austin Baeth, D-Des Moines, said he was conflicted on the legislation because of his experience working as a doctor in Iowa. Human errors have ended the careers and practices of some of his colleagues in lawsuits, he said, and he believes action must be taken to help hospitals at risk of closing down because of economic burdens.

But the $1 million limit is unfair to victims who have to live with the damages caused in these cases for the rest of their lives, he said. After attorneys take a 40% fee from the $1 million settlement, that person will be left with $600,000.

“Six hundred thousand dollars, for somebody who may be disfigured for the rest of their lives, somebody who may go through pain and suffering for the rest of their life,” Baeth said. “And in 2023, because we all know, $600,000 doesn’t get you as far as it once did 30 years ago.”

Meyer disagreed with Baeth’s characterization, arguing that other awards, such as for economic damages or punitive malice, are not limited by the law and will support people permanently impacted a medical malpractice case. But she said legislators need to look at the bigger picture on how these costs impact access to health care in rural Iowa.

“Maybe there’s some people out there that don’t think access is a big problem,” Meyer said. “You’ll think it’s a big problem when you’re having a heart attack and you don’t have a hospital within 20 minutes. You’ll think it’s a big problem when your wife’s pregnant and about to deliver a baby and there’s not a hospital within an hour.”

Lawmakers have not announced a date for floor debate.