Protecting Access to Care Act

Summary

H.R. 1215 reforms medical litigation laws where coverage was provided or subsidized by the federal government, including through a subsidy or tax benefit. Specifically, the legislation establishes a default $250,000 cap on noneconomic damages, limits the contingency fees lawyers can charge to maximize patient recovery, and establishes a fair share rule, by which damages are allocated in direct proportion to fault. The bill does not preempt any state law that limits damages at higher or lower amounts. To avoid bankruptcies, courts can require periodic payments for future damages instead of lump sum awards. The legislation requires full compensation for 100% of plaintiffs’ economic losses, including medical costs, lost wages, future lost wages, rehabilitation costs, and any other economic out-of-pocket loss suffered, and does not preempt certain other state laws and federal vaccine injury laws and rules.

Background

The State of California enacted the Medical Injury Compensation Reform Act of 1975 to lower medical malpractice liability insurance premiums for healthcare providers. Like H.R. 1215, the California law established a cap on noneconomic damages of $250,000, limited the contingency fees lawyers could charge, and established a fair share rule.[2] For a list of medical malpractice laws by state, please see here.  

 According to Chairman Goodlatte, “Americans continue to be frustrated with the rising costs of healthcare, and look to their elected representatives in Washington to take action to counter the catastrophic effects of Obamacare. The Protecting Access to Care Act will help keep the rising costs of healthcare from being passed along to the American people. The Congressional Budget Office estimates that the reforms contained in the bill would lower health care costs by tens of billions of dollars.”

Washington, D.C. – House Judiciary Committee Chairman Bob Goodlatte (R-Va.) delivered the following remarks during the House Judiciary Committee’s markup of the Protecting Access to Care Act (H.R. 1215).

Chairman Goodlatte: The bill is modeled on California’s highly successful litigation reforms that have lowered health care costs and made health care much more accessible to the people of that state.

Because the evidence of the effects of those reforms on lowering health care costs is so overwhelming, the Congressional Budget Office has estimated that if the same reforms were applied at the federal level, they would save over $50 billion over a ten-year period. And because the evidence that those reforms increase access to health care is so overwhelming, they are supported by a huge variety of public safety and labor unions, community clinics and health centers, and organizations dedicated to disease prevention — all of whom have seen the beneficial effects of these reforms in California. So popular are these reforms among the citizens of California that a ballot initiative to raise the damages cap, backed and funded by trial lawyers, was defeated by an over 2 to 1 margin in 2014.

This bill’s common-sense reforms include a $250,000 cap on noneconomic damages and limits on the contingency fees lawyers can charge. They allow courts to require periodic payments for future damages instead of lump sum awards so bankruptcies in which plaintiffs would receive only pennies on the dollar can be prevented.  And they include provisions creating a “fair share” rule, by which damages are allocated fairly in direct proportion to fault.

And this bill does all this without in any way limiting compensation for 100% of plaintiffs’ economic losses, which include anything to which a receipt can be attached — including all medical costs, lost wages, future lost wages, rehabilitation costs, and any other economic out of pocket loss suffered as the result of a health care injury.  Far from limiting deserved recoveries in California, these reforms have led to medical damages awards in deserving cases in the 80 and 90 million dollar range.

Unlike past iterations, this bill only applies to claims concerning the provision of goods or services for which coverage is provided in whole or in part via a Federal program, subsidy, or tax benefit, giving it a clear federal nexus. Wherever federal policy affects the distribution of health care, there is a clear federal interest in reducing the costs of such federal policies.

The legislation before us today also protects any State law that otherwise caps damages or provides greater protections that lower health care costs.

When President Ronald Reagan established a special task force to study the need for federal tort reform, that task force concluded as follows: “In sum, tort law appears to be a major cause of the insurance availability [and] affordability crisis which the federal government can and should address in a variety of sensible and appropriate ways.”  Indeed, the Reagan task force specifically recommended “eliminate joint and several liability,” “provide for periodic payments of future economic damages,” “schedule [that is, limit] contingency fees” of attorneys, and “limit non-economic damages to a fair and reasonable amount.” All of these recommended reforms are part of the bill before us today.

I urge my colleagues to support this legislation that would enact much-needed, common-sense, and cost-saving litigation reforms that would increase health care accessibility for all.

Click here to learn more about today’s markup.

H.R. 1215 would limit the legal rights of injured patients and families of those killed or injured as a result of negligent health care.  The bill would limit lawsuits involving medical malpractice, unsafe drugs, and nursing home abuse and neglect. 

H.R. 1215 proposes to make dangerous and potentially unconstitutional changes to our nation’s federal system, intruding on state sovereignty through the preemption of several areas of tort law that have traditionally been reserved to the states.  Respecting state sovereignty over medical malpractice makes sense because health care providers are licensed by the states, are expected to adhere to state standards, and are monitored by state authorities. 

H.R. 1215 would also make it more difficult for plaintiffs to seek fair redress for medical injuries that have been proven in court.  For example, the bill eliminates joint and several liability in health care lawsuits for both economic and non-economic damages claims.  By eliminating joint and several liability, a victim could be deprived of full compensation for damages and injuries.  One of the arguments proponents use for the passage of H.R. 1215 is that it would save money and cut health care costs, but besides the fact that the Congressional Budget Office (CBO) has found the savings to be minimal, the elimination of joint liability for economic loss would hurt taxpayers as injured patients would turn to programs like Social Security Disability Insurance and Medicare due to uncompensated financial loss. 

Additionally, the legislation would cap non-economic damages (damages for pain and suffering) at $250,000, regardless of the number of parties against whom the action has been brought. For example, in a medical injury proven to have been caused by the combination of a careless attending physician using poorly maintained medical equipment to administer a faulty drug, the total non-economic damages that could be awarded to a plaintiff would be $250,000, notwithstanding the separate culpability of the medical practice, the hospital, and the manufacturer of the drug. 

The legislation would also impose restrictions on plaintiff’s attorney fees.  This provision would likely discourage patients or families of limited financial means – frequently women, children, the elderly, and the disabled – from pursuing medical malpractice claims.

Medical errors, many of which are preventable, are the third leading cause of death in the U.S. Rather than shield negligent or careless health care providers from accountability and expose patients to avoidable harm, as H.R. 1215 would do, Congress should focus on improving patient safety and reducing deaths and injuries.

Medical errors claim the lives of as many as 440,000 Americans per year.  The thousands of lives lost every year is in addition to victims who suffer life-altering, debilitating injuries who deserve to be compensated for their physical, emotional, and economic damage.  H.R. 1215 makes is nearly impossible for victims to be fully compensated for malpractice committed by doctors, hospitals, nursing homes, and long-term care facilities.