About Proposition 46

Proposition 46, officially titled the “Troy and Alana Pack Patient Safety Act of 2014,” is a ballot initiative that will go before California voters in November 2014. If approved, it will enact important changes to how payments in medical malpractice cases are calculated.

Current cap is $250,000

California’s Medical Injury Compensation Reform Act of 1975 (MICRA) limits (or “caps”) to $250,000 the amount a plaintiff alleging instances of medical malpractice can recover at trial for noneconomic damages such as pain, suffering, emotional distress, or mental anguish. (Economic damage awards, for out-of-pocket expenses such as medical care costs or wage loss, are not capped.) A jury can award whatever amount it believes is appropriate for noneconomic loss, but following the verdict the judge will reduce that portion of the award to $250,000 (if necessary) prior to entering the final judgment in the case.

California would join three other states with similar caps

Map of the United States showing which states have limits on noneconomic damages

Twenty-eight states currently have no limits on damages; 22 states have some limits.

If Proposition 46 passes, California’s cap on noneconomic damages would increase to more than $1 million from the current cap of $250,000.

If passed, the new cap would rise to over $1.1 million

The cap on noneconomic damages has remained fixed at $250,000 since MICRA’s passage nearly 40 years ago. If approved by voters in California, Proposition 46 will increase the state’s cap to more than $1 million to take into account inflation that has occurred since 1975. It also will automatically increase the cap in future years according to the rate of inflation.

The initiative also will (LAO 2014):

  • Require healthcare providers to check a statewide database prior to prescribing certain drugs for the first time in an effort to curb prescription drug abuse.
  • Require hospitals to subject certain physicians to random drug and alcohol testing.
  • Require the California Medical Board to discipline physicians who have been found to be practicing while impaired by drugs or alcohol.
  • Require healthcare practitioners to report information suggesting drug or alcohol impairment or medical negligence by their colleagues.