Historic Bill to Modernize California’s Medical Injury Compensation Reform Act Passes Assembly with Overwhelming Support

With a 66 - 0 vote, AB 35 now moves to Governor’s desk 

Sacramento - Today, in a momentous vote, the Assembly passed AB 35 (Reyes, Umberg) 66 to 0. The bill, which modernizes California’s Medical Injury Compensation Reform Act (MICRA), will now move to the Governor’s desk for signature.

“Today’s vote confirms the broad based support for the compromise reached on MICRA,” said Lisa Maas, Executive Director of Californians Allied for Patient Protection. “This bill will help to ensure health care providers can keep their doors open while also balancing the financial needs of patients with health care related injuries. We applaud the work of the Assembly for their commitment to move this bill to Governor Newsom.”

The bill passed out of the Senate last week with a nearly unanimous vote.

“For nearly 50 years MICRA closed the door to justice for patients injured by medical negligence,” said Nick Rowley, author and principal funder of the Fairness for Injured Patients Act.  “This agreement makes the law better and will help injured patients have better access to the courts and increase accountability in health care. The legislative resolution we reached ends a decades long political fight that pitted patients and families against insurance companies. Solving our most protracted problems requires us to listen to each other and keep an open mind. That’s what happened here, and is an example hope others will follow.”

“The Assembly's passage of this historic compromise affirms the important principle that injured patients deserve to be fairly compensated when they have been harmed by medical negligence,” said Craig M. Peters, President of the Consumer Attorneys of California (CAOC). “CAOC is grateful for the determined efforts of injured patients and their families, who have fought against MICRA and have been the spearhead of the fifty-year fight to restore access to justice.”

After decades of political debate, this updated framework will extend the long-term predictability and affordability of medical liability protections for those providing medical care in California while providing a fair and reasonable increase to limits on non-economic damages for medical negligence beginning January 1, 2023, with gradual increases thereafter.

The legislation will most notably adjust MICRA’s cap on non-economic damages, which is currently limited to $250,000.  This new law will increase the existing limit to $350,000 for non-death cases and $500,000 for wrongful death cases on the effective date January 1, 2023, followed by incremental increases over 10 years to $750,000 for non-death cases and $1,000,000 for wrongful death cases, after which a 2.0% annual inflationary adjustment will apply.

The proposal will also create three separate categories of caps, which could apply depending on the facts of each case.  Additionally, a health care provider or health care institution can only be held liable for damages under one category regardless of how the categories are applied or combined. The new categories include:

Proponents of the measure will have it removed from the ballot in advance of the June 28, 2022 deadline.

What They’re Saying: Health Care Providers, Community Health Centers, Elected Officials and Local Leaders Applaud Historic Compromise on California’s Medical Injury Compensation Reform Act (MICRA)

Sacramento – Health care providers, community health centers, elected officials and local leaders have resoundingly supported a compromise announced last week that would modernize California’s Medical Injury Compensation Reform Act (MICRA) and preclude a costly ballot measure this fall. The framework was adapted into Assembly Bill 35 (Reyes, Umberg) and overwhelmingly passed out of the Senate today.

Governor Gavin Newsom:

“This agreement signals the end to one of the most long standing battles in California politics, and strikes a fair balance protecting patients, while ensuring that physicians and other medical professionals can treat patients without fear of financial ruin,” said Governor Newsom. “This is an important victory for the stability and health of our healthcare system, and for patients across California.”

Senate President pro Tempore Toni G. Atkins (D-San Diego):

“This bill will go a long way to help patients and their families seek justice when injured after obtaining care,” said Senate President pro Tempore Toni G. Atkins. “The collaborative effort from all sides will ultimately strengthen protections for Californians and I’m appreciative to my colleagues, Assemblymember Eloise Gómez Reyes and Senator Tom Umberg, for their leadership, and to the coalition, Governor Gavin Newsom, and Speaker Anthony Rendon, for their dedication to help settle this issue for the public good.”

Assembly Speaker Anthony Rendon (D-Lakewood):

“This is a strong accomplishment and I want to thank all parties for working out a deal,” said Assembly Speaker Anthony Rendon (D-Lakewood). “This includes Majority Leader Eloise Reyes for her hand in the process. This is a great example of what can be accomplished when historically opposing sides talk with one another. The people of California benefit.”

Assembly Majority Leader Eloise Gomez Reyes (D-Inland Empire):

“Times have changed, but MICRA hasn’t. Although there have been countless efforts to update the language in the Medical Injury Compensation Reform Act, there has been little success,” said Assembly Majority Leader Eloise Gomez Reyes, the enabling bill’s lead author. “This year, the stakeholders representing patients and the medical community were determined to provide a balanced and equitable solution. They have succeeded. The result is AB 35, which represents a monumental agreement for the benefit of all involved.”

Senator Tom Umberg (D-Santa Ana):

“As Chair of the Senate Judiciary Committee and a practicing attorney, I know first-hand that an update to California’s medical malpractice statutes is long overdue,” said the bill’s Senate author, Senator Tom Umberg. “I’m impressed with the work that has gone into this proposal by all stakeholders and proud to be playing a role in restructuring the system in a manner that is fair to all parties.”

Senator Patricia Bates (R- Laguna Niguel):

“It’s in the best interests of our health care system to end the contentious debates on MICRA that have long plagued Sacramento,” said Senator Patricia Bates. “AB 35 opens a future of predictability and accessibility that have been challenged time and time again with expensive ballot measures and political infighting. I look forward to working with my colleagues to swiftly move this bill to the Governor’s desk.”

Senator Brian Jones (R-Santee):

“AB 35 puts special interest aside and prioritizes patients and accessible health care,” said Senator Brian Jones. “I’m proud to support this historic bill that will promote stability in our health care delivery system for decades to come.”

Senator Scott Wilk (R-Santa Clarita):

“This bill provides a critical update to the law that will ensure patients remain the priority and health care providers can keep their doors open in underserved areas of California,” said Senator Scott Wilk.

Californians Allied for Patient Protection:

“We have long advocated for policies that protect both patients and the essential guardrails established under MICRA that ensure broad-based access to care for all Californians,” said Lisa Maas, Executive Director, Californians Allied for Patient Protection. “Today’s announcement demonstrates a unified commitment by all stakeholders to put the interests and wellbeing of Californians first.”

Charles Johnson, Chair of the Fairness for Injured Patients Act:

“This is about justice for families, especially women of color who experience more medical negligence in a biased health care system and then are denied accountability because of California’s outdated cap,” said Charles Johnson, Chair of the Fairness for Injured Patients Act. “When the Legislature approves this compromise, families will finally be able to find an attorney and have their day in court. That’s what I wanted for Kira. I want to be able to tell my sons that we restored Californians’ access to justice.”

California Medical Association:

“This balanced proposal represents a historic opportunity to modernize and update MICRA while preserving its essential guardrails, strengthening provider protections and providing fair compensation for injured patients,” said Robert E. Wailes, M.D., President of the California Medical Association. “We appreciate the Legislature and the Newsom Administration for their work in enacting this watershed agreement that will ensure a brighter future for California’s health delivery system.”

Nick Rowley, Author of the Fairness for Injured Patients Act:

“After nearly 50 years of inaction on a law that capped the value of human life and losing my own son to medical negligence, I wrote and funded the Fairness for Injured Patients Act to effectuate much-needed change,” said Nick Rowley, author and primary funder of the November ballot measure. “I never envisioned a legislative compromise, but I’m very proud that our work has led us to this point. When this becomes law, we will have changed history for the better.”

Consumer Attorneys of California:

“CAOC has fought tirelessly alongside thousands of injured patients for the last fifty years to make sure they are fairly compensated when their rights have been violated,” said Craig Peters, President, Consumer Attorneys of California. “After decades of impasse, we have finally reached an historic agreement with medical providers that finally updates California’s Medical Injury Compensation Act of 1975 to prioritize patients’ access to justice and quality health care.”

California Dental Association:

“This is a rare opportunity to achieve long-term stability and certainty about the future of the state’s MICRA law,” said CDA President Dr. Ariane Terlet. “This agreement is in the best interest of patients and providers because it will protect patient access, ensure high-quality care and continue to contain health care costs as opposed to the sudden, drastic cost increases this year’s ballot measure or future measures would bring.”

California Primary Care Association:

“Community health centers share a common mission of providing community based, high-quality access to health care that is culturally competent and accessible to all,” said Francisco Silva, President and CEO of the California Primary Care Association. “This legislative proposal provides a balance that will protect our community health centers financial ability to provide such comprehensive health care while also advancing our patient’s wellbeing.”

California Hospital Association:

“AB 35 puts Californians first by extending important guardrails within our legal system that help ensure health care is accessible to all Californians, while at the same time securing a path toward fair compensation for patients who have experienced a health care-related injury,” said Carmela Coyle, President & CEO of the California Hospital Association and Board Chair of CAPP. “We are proud to support AB 35 because it creates a stronger health care system for California, and peace of mind for patients and their families.”

Central Valley Health Network:

“As a network of more than 300 community health center sites that serve some of California’s most vulnerable patients, it’s a relief to see that AB 35 will take the place of a costly ballot fight this November,” said Jason Vega, Central Valley Health Network CEO. “Our health centers serve hundreds of thousands of Californians and ensuring we have the capacity to keep our doors open and provide critical care to some of our most underserved is essential to our state’s safety net.”

Community Clinic Association of Los Angeles County:

“The Community Clinic Association of Los Angeles County (CCALAC), which represents more than 65 nonprofit health centers across LA County, is glad to see patients being put above special interests,’ said Louise McCarthy, President and CEO of CCALAC. “AB 35 will ensure that health centers are able to keep their doors open and serve the communities that depend on our care.”

La Clinica de La Raza:

“La Clínica was founded on a simple mission: that every person deserves access to high-quality, culturally appropriate health care, regardless of their ability to pay,” said La Clínica de La Raza CEO Jane Garcia. “We are glad to see AB 35 will replace a dangerous ballot measure that would have decimated our ability to continue providing care to some of the Bay Area’s most vulnerable patients.”

California Association for Nurse Practitioners:

“The California Association for Nurse Practitioners (CANP) is committed to bridging gaps in the health care delivery system and meeting the needs of patients,” said Patti Gurney, MSN, PCPNP-BC, President of CANP.  “We are pleased to support AB 35 because the legislation meets our mission and will preclude a costly ballot measure that would have jeopardized access to care and increased health care costs for all Californians.”

Planned Parenthood Affiliates of California:

“This compromise will help to ensure that community health centers across California that serve some of our state’s most vulnerable patients, will have continued access to safe, affordable health care,” said Jodi Hicks, Planned Parenthood Affiliates of California President and CEO. “It was important for Planned Parenthood to have a voice in this process because the proposed initiative would have caused significant harm to California’s safety net. We’re pleased to see a solution that creates long term stability and protects access to care for those who need it most.”

Birth Equity Advocacy Project:

"When this legislation passes, families of color and low-income families will, for the first time, have a true path to justice and accountability for themselves and their loved ones,” said Morgan White, Director of the Birth Equity Advocacy Project. “For Black moms this is monumental."

California’s Legislative Leaders Join Health Care Providers, Consumer Attorneys and Patient Advocates in Announcing Landmark Agreement to Modernize California's Medical Injury Compensation Reform Act (MICRA)

SACRAMENTO – In a historic agreement, California’s legislative leaders today joined with Californians Allied for Patient Protection, Consumer Attorneys of California and both the Yes and No campaigns of a scheduled November ballot measure to announce a new consensus has been reached between health care, legal and consumer advocates on legislation to modernize the Medical Injury Compensation Reform Act (MICRA).

MICRA, first passed and signed into law by Governor Jerry Brown in 1975, was established to set limits on medical malpractice awards, balancing compensatory justice for injured patients against important legal and financial protections for health care providers.  After decades of political debate, this updated framework will extend the long-term predictability and affordability of medical liability protections for those providing medical care in California while providing a fair and reasonable increase to limits on non-economic damages for medical negligence beginning January 1, 2023, with gradual increases thereafter.

“This bill will go a long way to help patients and their families seek justice when injured after obtaining care,” said Senate President pro Tempore Toni G. Atkins (D-San Diego). “The collaborative effort from all sides will ultimately strengthen protections for Californians and I’m appreciative to my colleagues, Assemblymember Eloise Gómez Reyes and Senator Tom Umberg, for their leadership, and to the coalition, Governor Gavin Newsom, and Speaker Anthony Rendon, for their dedication to help settle this issue for the public good.”

“This is a strong accomplishment and I want to thank all parties for working out a deal,” said Assembly Speaker Anthony Rendon (D-Lakewood). “This includes Majority Leader Eloise Reyes for her hand in the process. This is a great example of what can be accomplished when historically opposing sides talk with one another. The people of California benefit.”

“We have long advocated for policies that protect both patients and the essential guardrails established under MICRA that ensure broad-based access to care for all Californians,” said Lisa Maas, Executive Director, Californians Allied for Patient Protection. “Today’s announcement demonstrates a unified commitment by all stakeholders to put the interests and wellbeing of Californians first.”

The legislation will most notably adjust MICRA’s cap on non-economic damages, which is currently limited to $250,000.  This new law will increase the existing limit to $350,000 for non-death cases and $500,000 for wrongful death cases on the effective date January 1, 2023, followed by incremental increases over 10 years to $750,000 for non-death cases and $1,000,000 for wrongful death cases, after which a 2.0% annual inflationary adjustment will apply.

“After nearly 50 years of inaction on a law that capped the value of human life and losing my own son to medical negligence, I wrote and funded the Fairness for Injured Patients Act to effectuate much-needed change,” said Nick Rowley, author and primary funder of the November ballot measure. “I never envisioned a legislative compromise, but I’m very proud that our work has led us to this point. When this becomes law, we will have changed history for the better.”

“CAOC has fought tirelessly alongside thousands of injured patients for the last fifty years to make sure they are fairly compensated when their rights have been violated,” said Craig Peters, President, Consumer Attorneys of California. “After decades of impasse, we have finally reached an historic agreement with medical providers that finally updates California’s Medical Injury Compensation Act of 1975 to prioritize patients’ access to justice and quality health care.”

“This balanced proposal modernizes and updates MICRA while preserving its essential guardrails, strengthening provider protections and providing for fair compensation for injured patients,” said Dustin Corcoran, CEO of the California Medical Association and Chair of the Campaign to Protect Access and Contain Costs. “This framework is essential to our shared goal of health access for all Californians.  We look forward to working with the Legislature and the Newsom Administration to enact this historic proposal.”

The proposal will also create three separate categories of caps, which could apply depending on the facts of each case.  Additionally, a health care provider or health care institution can only be held liable for damages under one category regardless of how the categories are applied or combined. The new categories include:

“Times have changed, but MICRA hasn’t. Although there have been countless efforts to update the language in the Medical Injury Compensation Reform Act, there has been little success,” said Assembly Majority Leader Eloise Gomez Reyes (D-Inland Empire), the enabling bill’s lead author.  “This year, the stakeholders representing patients and the medical community were determined to provide a balanced and equitable solution.  They have succeeded.  The result is AB 35, which represents a monumental agreement for the benefit of all involved.”

“As Chair of the Senate Judiciary Committee and a practicing attorney, I know first-hand that an update to California’s medical malpractice statutes is long overdue,” said the bill’s Senate author, Senator Tom Umberg (D-Santa Ana). “I’m impressed with the work that has gone into this proposal by all stakeholders and proud to be playing a role in restructuring the system in a manner that is fair to all parties.”

“This is about justice for families, especially women of color who experience more medical negligence in a biased health care system and then are denied accountability because of California’s outdated cap,” said Charles Johnson, Chair of the Fairness for Injured Patients Act. “When the Legislature approves this compromise, families will finally be able to find an attorney and have their day in court. That’s what I wanted for Kira. I want to be able to tell my sons that we restored Californians’ access to justice.”

​​“This compromise will help to ensure that community health centers across California that serve some of our state’s most vulnerable patients, will have continued access to safe, affordable health care,” said Jodi Hicks, Planned Parenthood Affiliates of California President and CEO. “It was important for Planned Parenthood to have a voice in this process because the proposed initiative would have caused significant harm to California’s safety net. We’re pleased to see a solution that creates long term stability and protects access to care for those who need it most.”

Once passed and signed by the Governor, this legislative framework will preclude a costly ballot measure that was set to appear on the November ballot.