preserving access – protecting patients

California’s Medical Injury Compensation Reform Act (MICRA) ensures injured patients receive fair compensation while preserving access to health care by keeping doctors, nurses and health care providers in practice and hospitals and clinics open. Prior to MICRA, out-of-control medical liability costs were forcing health care providers out of practice. MICRA was intended to, and has been successful in, stabilizing liability costs. In 2014, California voters definitively rejected Proposition 46, an attempt to quadruple MICRA’s non-economic damages cap.

Protecting Patients’ Rights and Preserving Access to the Courts

  • MICRA provides for:


  • MICRA also limits attorneys’ fees so patients, not lawyers, receive more from awards.

MICRA Ensures Fair Compensation while Stabilizing Premiums

  • MICRA has successfully stabilized professional liability premiums, enabling more providers to remain in practice. States without medical liability reform suffer from shortages of providers leading to the closing of hospitals, clinics and trauma centers and leaving patients with no doctors in their immediate vicinity.

Protecting Access to Health Care Services

  • MICRA is especially critical in protecting access to specialty and high-risk services, including women’s health care, community clinics, health centers, and rural providers that can least afford skyrocketing costs.
  • With more lawsuits, medical liability rates for rural and urban community clinics that provide care to underserved Californians will increase. Higher costs would then be offset elsewhere, either through a reduction in services, staff, operating hours, or services offered.
  • Since enacting medical liability reforms in 2003, Texas has added more than 16,000 in-state, active physicians, far outpacing population growth during this time. Compare this to New York, a state without reforms, where 19 counties are without an obstetrician, 22 have no internal medicine specialists and 15 do not have surgical specialty doctors.
  • According to California’s former Legislative Analyst, by defeating Proposition 46 in 2014, Californians have saved $19.8 billion over the last two years – or $2,000 for a family of four.

Supported by a Large and Diverse Coalition of Patient Advocates and Health Care Providers

  • Californians Allied for Patient Protection (CAPP) protects patient safety and access to health care through MICRA. CAPP’s coalition includes health care professionals and organizations representing community clinics, public safety organizations, patient advocates, physicians, nurses, dentists, hospitals, health facilities, and women’s health advocates, among others.

“If MICRA is changed and our medical liability rates go up…it’s our patients, mostly low-income and people of color with few health options, who will lose access to needed health care services… We should be focused on lowering health care costs to expand access to care, not the other way around.”

Jim Mangia

President and CEO, St. John’s Well Child & Family Center