Lessons for Albany on Malpractice Limits

But other states that have similar caps in place offer cautionary evidence about the big savings for health care providers that such limits are believed to produce.

In 1975, California lawmakers approved a $250,000 cap on so-called noneconomic damages in cases of medical mistakes, which has since become a model for similar proposals. At least 35 states now have at least some limits on malpractice damages.

The California law has also been the focus of long-running debate over who benefits from caps — doctors or insurers — and whether the measures inflict unintended negative consequences upon victims of medical errors, including plaintiffs’ inability to find lawyers to take their cases.

In the early years after California enacted its cap, doctors did not see the cost of their insurance policies plummet. From 1976 to 1986, the total paid in premiums increased 176 percent, according to the National Association of Insurance Commissioners. (Nationally, premiums rose 221 percent.)

California and three other states that had $250,000 caps in place in 1991 saw premiums increase 28 percent in the following decade, compared with a 48 percent increase in other states, according the Physician Insurers Association of America.