Proposition 12 Produces Healthy Benefits

Texas' 2003 medical liability reforms have kept their promises. The landmark law and accompanying constitutional amendment have assured good Texas physicians they can take on the most complicated illnesses and serious injuries without fear of facing a groundless lawsuit in return, and attracted record numbers of new physicians to the state. 

Improving access to medical care is critically important to all Texans.  

  • This is especially true for children, pregnant women, the aged, the poor, those in an emergent condition and those in rural Texas.

Charity care has greatly increased since the passage of the 2003 reforms.

  • Texas hospitals have doubled their provision of charity care in the initial 11 years following the passage of lawsuit reform. Collectively, the state’s hospitals spent $1.69 billion out-of-pocket to render charity care in 2003. That number rose to $3.36 billion in 2014 (the most current year for which data is available). Without the passage of the 2003 reforms, Texas hospitals would not have the wherewithal to provide this enormous amount of free care. Thus many of the state’s hospitals would have been left with the stark choice of turning away charity care patients or closing their doors altogether.
  • Hospitals have reinvested their liability savings into new technology, patient care, and patient safety, and have doubled the amount of charity care they provided 11 years ago. Without reforms and the attendant liability savings, these achievements would have impossible.

    Charity care is care for which the hospital never expected to be reimbursed. This number does not include bad debt written off for care for which the patients is unable or unwilling to pay.

Physician Growth vs PopulationHouse Bill 4 (the 2003 medical liability reforms) has a track record of improving access to medical care.  

  • 2001: Texas licensed 2,088 new doctors, the fewest in a decade.
  • 2015: Texas licensed 4,295 new doctors, the highest number of any year on record.
  • The Texas Medical Board reports that the state is on pace to surpass that number by 5 percent this year.
  • The Association of American Medical Colleges collects comparative data on physician supply in all 50 states. During the past six years, only California has added more patient care doctors than Texas. Only four states bested Texas in percentage growth. Since 2008, the Lone Star State has ranked 20th in per capita physician growth; a remarkable accomplishment given our explosive population growth.
  • More than two-thirds of the state’s 22 trauma service areas experienced a per capita loss in patient care physicians during the liability crisis years.
  • Since then, 80 percent of the state’s trauma service areas have experienced a per capita gain.
  • Since 2003, Texas has added 9,273 more in-state active physicians than can be accounted for by population growth. 
  • Population growth may well account for 51 percent of the state’s new physicians. The other 49 percent above the trend were produced by some other factor. Many of the state’s newly-minted doctors have cited Texas’ more hospitable legal climate as a significant factor in their choosing to practice here.
  • Statewide, the accelerated growth rate in the Texas physician workforce has produced the opportunity for 36.7 million more patient visits per year than likely would have occurred absent tort reform. 

Physician growth is not limited to metro Texas.

  •  Since 2003, the ranks of rural obstetricians have grown more than twice as fast as the state’s rural population. 
  • Some 28 rural Texas counties have added at least one obstetrician, including 11 counties that added their first.
  • 56 rural counties have added an emergency medicine physician. 40 of those counties added their first ER doc. 
  • 19 counties added their first cardiologist; 14 of those counties are rural.
  • 54 counties have seen a net gain in orthopedic surgeons since 2003; 11 counties have added their first orthopedic surgeon; and 18 of the counties that have added an orthopedist are rural. 
  • 29 rural counties added at least one general surgeon, and 10 counties added their first general surgeon.
  • Five Texas counties added their first neurosurgeon and two of those counties are rural.  

Premiums are stable and declining.

  • Insurance premiums for most Texas doctors have been cut in half or more since the passage of reforms.

Claims and lawsuits in most Texas counties have been cut in half.


Updated April 2016

Related Information