H.R. 1215, Protecting Access to Care Act of 2017

H.R. 1215 would impose limits on medical malpractice litigation in state and federal courts by capping awards and attorney fees, modifying the statute of limitations, and eliminating joint and several liability.

CBO expects that enacting H.R. 1215 would, on balance, lower costs for health care both directly and indirectly: directly, by lowering premiums for medical liability insurance; and indirectly, by reducing the use of health care services prescribed by providers when faced with less pressure from potential malpractice suits. Those reductions in costs would, in turn, lead to lower spending in federal health programs and to lower premiums for private health insurance.

In total, CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting the legislation would reduce deficits by about $14 billion over the 2017-2022 period, and almost $50 billion over the 2017-2027 period. Off-budget revenues account for about $2 billion of that reduction. CBO estimates that implementing the legislation would reduce discretionary costs by about $1.5 billion over the 2017-2027 period, assuming appropriations actions consistent with the legislation.

CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2028.

H.R. 1215 would preempt state laws governing health care lawsuits in the areas of statutes of limitation, joint and several liability, product liability, and contingency fees. Those preemptions would be intergovernmental mandates as defined in the Unfunded Mandates Reform Act (UMRA). The bill also would require courts (including state courts) to direct periodic payments of damages in some circumstances. CBO estimates that the costs of complying with those mandates would be insignificant and well below the threshold established in UMRA ($78 million in 2017, as adjusted for inflation).

This bill would impose private-sector mandates as defined in UMRA, on plaintiffs who file medical malpractice claims or medical product liability claims and on attorneys. CBO estimates that the aggregate cost of the mandates would exceed the annual threshold established in UMRA for private-sector mandates ($156 million in 2017, adjusted annually for inflation) in at least four of the first five years the mandates are in effect.