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HB 4 (2003) imposed strict caps on “noneconomic damages” in medical malpractice lawsuits in Texas.
- $250k cap against individual doctors/providers
- Up to $250k per healthcare institution
- Maximum generally capped around $750k total for pain-and-suffering damages
Economic damages were not capped.
Patients could still recover actual medical expenses, lost wages, rehabilitation costs, etc.
The legislation was designed to reduce malpractice insurance costs and discourage lawsuits that lawmakers considered excessive.
Supporters argued the reforms:
- lowered malpractice insurance premiums
- attracted more physicians to Texas
- improved access to healthcare, especially in rural areas
Critics argued the caps:
- made it harder for severely injured patients to obtain fair compensation
- disproportionately harmed children, elderly patients, and non-working victims
- reduced accountability for negligent healthcare providers
The report notes malpractice insurance rates in Texas generally declined after reform, though debate continued over whether tort reform alone caused that decline.
HB 4 worked together with Proposition 12, a constitutional amendment approved by Texas voters in 2003, which protected the caps from being struck down by courts.
The reforms became part of Texas Civil Practice & Remedies Code Chapter 74, which still governs Texas medical liability law today.