T-R PHOTO BY ROBERT MAHARRY McFarland Clinic’s Marshalltown location is pictured. The Iowa Legislature recently passed a bill that would cap the amount of noneconomic damages awarded in medical malpractice lawsuits at $2 million for hospitals and $1 million for clinics and individual providers.

DES MOINES — Since convening for the 90th General Assembly last month, the Republican-controlled Iowa Legislature has wasted no time getting to work on several of Gov. Kim Reynolds’s top priorities. After delivering a bill creating Education Savings Accounts to the governor’s desk, which she promptly signed, lawmakers moved on to capping the amount of noneconomic damages plaintiffs in medical malpractice lawsuits can receive at $2 million from hospitals and $1 million from clinics or individual providers.

Reynolds issued a statement late Wednesday after the legislation passed in both chambers, 54-46 in the House and 29-20 in the Senate, with some Republicans joining Democrats in voting against it.

“I’m grateful to the legislature for passing reasonable medical malpractice reform, allowing Iowa’s health care industry to become stronger and more accessible. To the OBGYNs and physicians who have been worried about practicing in Iowa, we are ready for you,” Reynolds said. “These reforms balance the needs of injured patients with the needs of all Iowans to have a robust health care system. As I said in my Condition of the State, these reforms could not wait another year.”

Alison Wilson, a medical doctor with McFarland Clinic in Marshalltown, counts herself in support of the bill and explained the difference between economic damages like medical expenses and lost wages, which have not been capped, and noneconomic damages like emotional stress, anguish and inconvenience.

“While there certainly is emotional distress and loss related to any injury or unexpected outcome, the current status provides no regulation of the amount of money that can be awarded for this particular aspect,” Wilson said. “Because there is no cap, the plaintiff and his or her attorney can demand astronomical amounts of money. In many of the large settlements that make the headlines, the unlimited non-economic awards are what make up most of these amounts. The proposed change would not eliminate the noneconomic awards, but set a realistic amount limit that could be applied fairly.”

Wilson added that Iowa is one of the only Midwestern states without a noneconomic damages limit, and she believes it is making the state less competitive in attracting top talent to practice medicine here.

“We provide good care and Iowa doctors are pretty conservative in nature. We don’t order a lot of extra tests or practice ‘defensively.’ However, doctors are retiring sooner, not going to the smaller towns where there is less specialty backup, and the young doctors are choosing to practice elsewhere due to the hostile litigious environment we are allowing,” she said. “Iowa is a wonderful place to live and work and raise a family, but we struggle to recruit people not originally from Iowa. We never used to get questions from medical students and residents about the malpractice environment, but now that is a standard question from provider candidates.”

On the flip side, Chip Baltimore, a former Republican state representative and longtime trial lawyer, does not believe the bill will achieve its intended goals of attracting more medical professionals to the state and keeping insurance rates down.

“I oppose this bill because the vast majority of the available evidence shows that all the cap will do is harm those innocent persons who are injured by the negligence of others. The evidence does not support the claims that this cap will increase access to health care, aid in recruiting new health care professionals, or lower malpractice insurance premiums. The evidence does not suggest that the former law without the cap caused any decrease in healthcare access or impeded that care in any way,” he said. “In reviewing the very few cases used by the medical industry as reasons to pass this law, the documentation shows that the medical insurance industry is refusing to negotiate reasonable settlements in good faith with injured persons, forcing the cases to trial and causing everyone to incur substantial expense and risk.”

Baltimore suggested a handful of other reasons why the state struggles to attract new medical providers: Iowa’s low medical reimbursement rate for Medicare, Medicaid, and health insurance, the feeling that they cannot earn enough in sparsely-populated areas to repay their student debt and a general desire to practice in urban areas with more to offer young individuals and families.

He also questioned members of his own party who claim pro-life principles but would support such a bill.

“The most ardent pro-life politicians, mostly Republicans, publicly claim that every life is priceless, and that we cannot put a price on life — and especially that the government cannot put a price on life. Yet, by enacting a law that limits the amount a person or family can receive from a negligent doctor or hospital to a set amount, that’s exactly what they have done – put a government-mandated, one-size-fits-all price on a life, regardless of the damages caused,” Baltimore said. “In addition, the medical industry and their insurance companies argue that if a baby dies as a result of medical negligence before it is born, it is not a person and therefore has sustained no damages. Zero dollars for the life of the baby.”

As this issue went to press, Reynolds had not yet signed the bill, but she is expected to do so soon. Among local legislators, Sen. Jeff Edler (R-State Center) and Rep. Dave Deyoe (R-Nevada) voted in favor, and Rep. Sue Cahill (D-Marshalltown) opposed it.