SOURCE: Des Moines Register

Gov. Kim Reynolds has signed a law limiting the amount of money Iowans can receive in medical malpractice lawsuits, touting the legislation as a win for health care access in rural Iowa.

“Everyone agrees that when mistakes happen Iowans deserve their compensation,” Reynolds said Thursday, before signing the law in her office at the Iowa Capitol. “But arbitrary multimillion-dollar rewards do more than that. They act as a tax on all Iowans by raising the cost of care. They drive medical clinics out of business and medical students out of the state. And they deter surgeons and specialists deciding where to practice from building their careers in Iowa.” 

The law limits damages for pain, suffering and emotional distress — known as noneconomic damages — in the most severe cases of medical malpractice, including when a patient dies or is permanently impaired.

Those damages will be limited to $2 million in lawsuits against hospitals and $1 million in lawsuits against clinics and individual doctors.

The law does not limit economic damages, such as money awarded for financial losses, or punitive damages in cases of “willful and wanton disregard” for a patient’s safety. 

The legislation is a win for Reynolds, who called for the limits in her Condition of the State address in January. But the victory came over heated disagreement from Republicans.

Eleven GOP lawmakers in the House and five in the Senate voted against the measure, criticizing members of their own party for what they said amounts to putting an arbitrary limit on the value of a person’s life.

Republican leaders also tried to pass limits on medical malpractice lawsuits last year, resulting in a rare failed floor vote in the Iowa House, as Republicans joined with Democrats to block the bill.

Reynolds acknowledged that difficulty Thursday, saying “this wasn’t our first attempt” to get the legislation passed.

“But as Iowans do, we persevered until the job was done, because it was the right thing to do,” she said.

Democrats criticized the law, saying it infringes on Iowans’ right to a jury trial while doing nothing to protect patient safety.

“Iowans have a right to a jury trial, they have a right to a jury of their own peers to award pain and suffering damages,” said House Minority Leader Jennifer Konfrst, D-Windsor Heights. “And that right has been taken away by special interests, particularly the insurance companies who are getting a lot of benefit out of this bill with no real cost.”

The law takes effect immediately, meaning the new limits will apply to any new incidents of medical error but not to existing lawsuits. The limit will increase by 2.1% per year beginning in 2028 to account for inflation. And the law also creates a new task force to study ways to reduce medical errors in Iowa.

Republican leaders are also advancing legislation that would place similar limits on damages in lawsuits over cases when commercial vehicle drivers injure or kill others in collisions. Identical bills are eligible for floor debate in the House and Senate.

How do Iowa’s medical malpractice limits compare to other states?

Several states have some form of limit on damages in medical malpractice cases, including several of Iowa’s neighbors.

South Dakota limits noneconomic damages in medical malpractice cases to $500,000, while Wisconsin sets its limit at $750,000 for each occurrence and Missouri has a similar limit. Nebraska has a $2.25 million limit on total damages — economic and noneconomic.

Iowa law already capped noneconomic damages in less severe medical malpractice lawsuits at $250,000 ― where patients didn’t suffer permanent impairment or death. The new law places a limit on the money awarded on those cases for the first time.

The Medical Liability Monitor, a specialty publication that focuses on medical malpractice insurance rates, lists Iowa as the fifth-lowest state in the country for medical malpractice insurance rates across all medical specialties.

But Reynolds insisted Iowa’s lack of stronger limits on damages was hurting the state’s ability to recruit health care workers.

“In the nationwide recruiting contest, states that chose not to protect their doctors, nurses and health care systems from out-of-control verdicts are effectively conceding the field to those who do,” she said.

Kevin Kincaid, CEO of Knoxville Hospital & Clinics, joined Reynolds at Thursday’s ceremony. He said the greatest risks to Iowans’ access to quality care “don’t come from medical mistakes, they come from a lack of providers.”

“To recruit the best and brightest, to keep these providers in Iowa, we need to have a stable practice environment,” he said. “This bill is a crucial step forward in helping Iowa be a more attractive place to practice medicine.”

How many medical malpractice verdicts are decided in Iowa each year?

Iowa juries have reached verdicts in only a few dozen medical malpractice cases in the last five years, with the vast majority of those decisions in favor of the defendant.

From 2018 to 2022, Iowa has seen 56 verdicts in medical and dental malpractice lawsuits. Of those, 48 verdicts have been in favor of the defendants, seven have been in favor of the plaintiffs and one resulted in a split verdict, according to data from the Iowa Judicial Branch.

That means medical providers being sued for malpractice have had roughly an 86% success rate at trial in recent years, Judicial Branch data shows.

Six Iowa cases in the last five years have resulted in verdicts for plaintiffs with damages greater than $1 million, including two cases in 2022, three in 2019 and one in 2018.

Over the same period, there have been 749 medical malpractice lawsuits filed in Iowa — an average of 150 per year. The vast majority of those suits do not reach trial.

The most recent report from the Iowa Insurance Division shows there were more than 500 claims handled by medical malpractice insurance companies in 2021 for allegations of misdiagnoses and treatment, delays in diagnoses and inappropriate surgical treatment, among a variety of other malpractice claims.

The 192 claims “closed” by insurers in 2021 totaled nearly $35 million. Of those, about a dozen claims had a total loss of at least $1 million, with the largest paid loss exceeding $4.5 million, the report states.