Medical Injury Compensation Reform Act of 1975 (MICRA)

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In 1975, the California legislature passed the Medical Injury Compensation Reform Act (MICRA), which put a cap of $250,000 on noneconomic damages in medical malpractice lawsuits. The law was somewhat controversial.

Proponents argued that the cap on noneconomic damages would help control medical malpractice insurance rates and consequently (1) help control overall health care costs and (2) keep more doctors in practice in California.
Opponents of the bill argued that in effect, it took away a plaintiff’s right to a jury trial in malpractice cases by dictating a maximum amount for noneconomic damages.

Although 29 states have some form of cap on damages in medical malpractice cases, 21 states have none. Some state constitutions prohibit such caps. In four states, caps on noneconomic damages have been declared unconstitutional.

From 1975 through 2022, the California medical malpractice cap imposed by MICRA remained unchanged, but as the years went by, there was increasing recognition that the law needed to be updated. For example, someone who had a catastrophic injury, such as an amputation , in the last few years would still only be able to collect $250,000 in noneconomic damages.

In 2014, a ballot proposition would have increased the cap to $1 million, but it was defeated at the polls. Another ballot initiative was slated to appear in November 2022, but in May 2022, legislators nearly unanimously passed updates to MICRA that resulted in the ballot initiative being withdrawn.

The updates to MICRA took effect on January 1, 2023. Let’s take a look at how they affect medical malpractice cases in California.

2022 California MICRA Updates

The updates to MICRA (like the original law) apply only to noneconomic damages, not to economic damages. California law does not cap economic damages in medical malpractice cases. In addition, the MICRA updates (again, like the original law) do not change the requirements for proving a medical malpractice case or determining fault.

New Caps on Noneconomic Damages

The most significant changes to MICRA in 2022 are increases in the caps placed on noneconomic damages.

In medical malpractice injury cases, the new cap on noneconomic damages is $350,000. This cap will increase by $40,000 each year for the next 10 years until it reaches $750,000. From then on, it will increase by 2% each year.
In medical malpractice wrongful death cases, the new cap on noneconomic damages is $500,000. This cap will increase by $50,000 each year for the next 10 years until it reaches $1 million. From then on, it will increase by 2% each year.

New Categories of Defendants

The updates to MICRA allow the new caps (covered above) to be applied to three categories of defendants:

Health care providers
Health care institutions
Health care providers or institutions not affiliated with any defendants in the first two categories

The $350,000 cap for medical malpractice injury cases and $500,000 cap for wrongful death cases apply to each category separately, regardless of the number of defendants within each category. This means:

If three health care providers from Category 1 are defendants in a wrongful death lawsuit, the sum of all noneconomic damages assessed against them collectively cannot exceed $500,000.
If there are defendants in all three categories in a medical malpractice injury lawsuit, a plaintiff could potentially be awarded noneconomic damages of $350,000 in each category, for a total of $1.05 million.

Other Changes to MICRA in 2022

Other notable updates to MICRA included in the 2022 legislation affect the following:

Attorney contingency fees : The 1975 law limited contingency fees based on the damages awarded in a settlement or jury decision. The 2022 update allows contingency fees of up to 25% if a case settles before going to binding arbitration or trial, and up to 33% if a case settles after going to arbitration or trial. Attorneys can also ask the presiding arbitrator or judge for a higher rate if a case goes to arbitration or trial.
Periodic payments : The 1975 law allowed either party in a lawsuit to request periodic payment of damages rather than a lump-sum payment if the damages exceeded $50,000. The 2022 update to MICRA keeps this provision but increases the threshold for requesting periodic payments to $250,000.
Expressions of sympathy, benevolence, or fault : The 1975 law stipulated that health care providers’ expressions of sympathy toward injured patients or their family members were not admissible as evidence in medical malpractice lawsuits. The 2022 updates to MICRA keep this protection but extend it further, stating that expressions of sympathy or condolences are confidential and not subject to subpoena or discovery in a lawsuit.

Experienced California Personal Injury Lawyers

If you think you may have a medical malpractice claim against a negligent health care provider in California, make sure your attorney is aware of the updates to MICRA that affect your case. The Bakersfield personal injury lawyers of Chain | Cohn | Clark are familiar with MICRA and the recent updates and can help you as you pursue your medical malpractice claim.