It has been almost four decades since California enacted its Medical Injury Compensation Reform Act (MICRA).

The law, which set caps on non-economic damages in medical malpractice cases, was enacted to deal with rising costs of malpractice insurance, increasing lawsuits, and physicians leaving medical practice because of these concerns. MIRCA capped non-economic damages at $250,000, but this sum in 1975 was worth a far less than in 2013. MICRA had no provisions for inflation.

MICRA was arguably successful in terms of keeping physicians in the state and reducing the cost and frequency of lawsuits. As a result of the cap never being raised (for inflation or otherwise), however, more attorneys are declining taking on medical malpractice cases due to the large outlay of time and low payoff.

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To address this growing concern, trial attorneys and Consumer Watchdog (a consumer advocacy group) have launched a campaign to qualify a ballot initiative for November 2014 to lift the cap on damages in California. Consumer Watchdog has stated that it will hold off on the campaign if the legislature reforms MICRA, but the influence that the medical lobby and insurance industry have on the legislature make this unlikely. Proponents of MIRCA argue that it has kept insurance rates down and kept physicians in the state, but opponents say that the only beneficiaries are insurers, as insurance companies are still charging excessive premiums to physicians (as evidenced by a 2012 insurance premium reduction ordered by the California Insurance Commissioner after he had asked the top six medical malpractice insurance companies to justify their rates).

One of the proponents of the campaign to change MICRA is former California Assemblyman Barry Keene, who originally sponsored the law, but now deems it “oppressive” and in need of revision.