Proposition 46: What Does the Research Say?

In November 2014, voters in California considered a ballot initiative — Proposition 46 — that would have modified the state's cap on non-economic damages in medical malpractice cases and enact safety measures related to physician drug abuse and medical prescribing. The current cap, set at $250,000 under the 1975 Medical Injury Compensation Reform Act (MICRA), would have been indexed to inflation, raising the cap level to approximately $1.1 million. This ballot initiative was widely viewed as a potential indicator for future efforts to modify damage caps in other states.

Objective Analysis about Prop 46

What does RAND research reveal about the potential effects of raising the limits on jury awards for non-economic damages in California? Below we address several common questions about Proposition 46 and its potential effects:

  1. Is there evidence that Proposition 46 would decrease the number of physicians willing to work in the state of California?
  2. Is there evidence that Proposition 46 would increase malpractice claim costs for physicians and their insurers?
  3. What is the likely effect of Proposition 46 on trial awards for medical malpractice plaintiffs?
  4. Would Proposition 46 it make it easier for injury victims to find attorneys to represent them?