Government Relations Advocacy Update
Volume 10, Issue 2
2025 Legislative Update
Most states adjourned their 2025 regular legislative sessions mid-year. A handful of states remain in regular session and a smattering of states have returned or are expected to convene special sessions to address budget and other issues. Adjacent to state activity, Congress continues its year-round activity, albeit in fits and starts.
While the pace of legislation activity has slowed, TDC Group’s Government Relations team continues to advocate on pending legislation, prepare with coalitions for the 2026 legislative sessions, and engage in key judicial actions warranting an amicus curiae voice.
The sheer volume of legislative activity in the country could be enough to stop most carriers’ government relations efforts in their tracks—but not our Government Relations team. With more than 150,000 bills introduced each year in state and federal legislatures, our team constantly monitors legislation that impacts our members and insureds, and advocates on their behalf.
Over the years, more than 30 states have enacted medical liability reform laws to promote access to healthcare; however, these laws are constantly under attack. Our team works continuously at the legislative level to counter such threats—as well as on the judicial level with a robust amicus curiae (friend of the court) brief program—to defend these hard-won protections.
2025 Public Policy Proposals by State
The following are summaries of a selection of the 2025 public policy proposals on our priority advocacy list and key amicus curiae activity.
SB 1342—Time-Limited Demands (Failed): This bill introduced onerous language involving time-limited demands for claim settlement. TDC Group worked with others in Arizona to defeat this bill.
AB 251—Elders and Dependent Adults (Enacted): This bill relates to spoliation of evidence in elder abuse claims. TDC Group worked with a coalition to secure amendments to mitigate the impact of this legislation on healthcare providers.
SB 29—Wrongful Death (Failed): This bill proposed to remove the sunset provision on CA SB 447 (2021) that allows heirs of a decedent to collect damages for the plaintiff’s pre-death pain and suffering. TDC Group fully engaged in defeating this bill or securing an amendment to carve out medical liability cases, as was anticipated when the MICRA changes were made in 2022. Through our advocacy, SB 29 has been defeated for this year, but it will resurrect in 2026 and we are actively working to ensure it does not become enacted.
SB 157—Deceptive Trade Practice (Failed): TDC Group worked with the Colorado healthcare coalition to defeat this bill that would have allowed a plaintiff to file a new kind of lawsuit against professionals, including healthcare providers, for deceptive trade practices.
HB 6017; SB 616; SB 734—Wrongful Death (Vetoed): Known as the “free kill bill,” these proposals would have allowed, in a wrongful death action, the parents of adult children to recover for the adult child’s pre-death pain and suffering if the adult child has no other heirs. This bill was passed by the legislature, but due to the advocacy of TDC Group and our allies, the Governor vetoed the bill. It is anticipated that this veto will not be overturned by the legislature.
SB 1284—Wrongful Death of an Unborn Child (Failed): This bill would have amended Florida’s wrongful death statutes to allow parents to seek damages for the wrongful death of an unborn child. It would have revised the definition of “survivors” to include the parents of an unborn child and defines the life of an “unborn child” as beginning at conception. The bill would have prohibited wrongful death claims against the mother and would have authorized parents to recover damages related to the loss. TDC Group worked with a coalition to defeat this bill.
SB 1520—Truth in Damages (Failed): This bill would have allowed evidence of the amount actually paid for medical expenses, reasonable and customary rates for medical services, or any other evidence that could be used to demonstrate the actual value of medical services provided in a medical liability case. TDC Group worked with a broad coalition of parties to see this legislation move forward but was unsuccessful in our efforts.
SB 1534—Litigation Financing (Failed): This legislation would have mandated disclosures regarding litigation financing agreements, including involvement by foreign entities, and allow for discovery of such agreements. It would have required litigation financiers to indemnify plaintiffs against specific costs and sanctions under certain conditions and would have declared litigation financing agreements void and unenforceable in specified circumstances. TDC Group worked with other insurers and national trade groups to see this legislation passed, but our efforts were unsuccessful.
SB 68—Civil Liability (Enacted): This comprehensive tort package includes an anti-anchoring provision, trial bifurcation, truth in damages, and venue changes. TDC Group was the only significant medical professional liability financial contributor to the effort and the only medical professional liability carrier that actively lobbied in support of the reforms. TDC Group successfully worked with a broad coalition to pass this legislation relatively intact; however, the truth in damages provision was watered down significantly.
SB 69—Civil Liability (Enacted): This law addresses issues with third-party litigation funding. TDC Group successfully worked with the same tort coalition as we did on SB 68 to support this bill.
SB 2063—Ob/Gyn Medical Liability Insurance (Failed): This bill would have required that medical malpractice insurance companies follow underwriting guidelines that consider whether an ob/gyn provides obstetric services, including childbirth, when calculating premiums. It was successfully killed in committee by TDC Group in collaboration with the medical association. However, Illinois has a “veto session” in the fall where a supermajority may resurrect a bill.
SB 2626—Contributory Negligence (Pending): This bill eliminates the instruction that a defendant is not liable if plaintiff is 50 percent or more at fault. TDC Group worked with the medical and insurance industry associations to kill this bill in committee. However, Illinois has a “veto session” in the fall where a supermajority may resurrect a bill.
SF 2/HB 256—Statute of Repose (Failed): These bills proposed that the six-year statute of repose does not apply in medical liability claims when the healthcare professional hides the cause of injury. A host of interests worked against the legislation including our insurance trade coalition and the state’s medical society. This bill was heard in the House Judiciary Committee but did not move in the Senate and it failed.
SF 84—Noneconomic Damages Cap (Failed): This bill would have repealed the noneconomic damages cap for catastrophic injury. Iowa currently has two noneconomic damages caps—$250,000 for routine medical liability claims and $1 million ($2 million when hospitals are part of the claim) for catastrophic injury claims. A host of interests advocated against the legislation including TDC Group through our insurance trade coalition and the state’s medical society. This bill did not have a hearing, and it failed.
SF 189—Sexual Assault Medical Malpractice (Failed): This bill stated that actions that are sexual in nature and occur while providing healthcare services are not subject to the state’s noneconomic damages cap. This bill did not have a hearing, and it failed.
SB 63—Gender-Affirming Care; Strict Liability and Insurer Paid Damages Prohibited (Enacted): Kansas enacted the “Help Not Harm Act” that prohibits healthcare providers from providing surgical and hormone gender-affirming care to minors (those under 18) with limited exceptions to allow for care related to medically verified sex development disorders. It authorizes a cause of action for both the individual and the individual’s parents. It includes a window of strict liability for physical, psychological, emotional, or physiological harms to an individual in the next 10 years from the date that the individual turns 18 years of age. All claims must be brought within 10 years from the date an individual turns 18. In addition, “[A] professional liability insurance policy issued to a healthcare provider shall not include coverage for damages assessed against the healthcare provider who provides treatment to a minor in violation” of the Act.
HB 34; SB 108; SB 150; SB 230 (Failed); SB 231 (Enacted)—Evidence of Medical Expenses (Failed): This set of legislation was aimed at changing Louisiana’s truth in damages provisions and could have allowed either party to introduce evidence of billed and paid medical expenses, after which the trier of fact would decide the “reasonable” medical expenses to be awarded. TDC Group worked with a coalition to defeat these bills, but SB 231 was enacted, weakening truth in damages by allowing parties to introduce evidence of both what was paid and what was billed for medical damages.
HB 435—General Damages in Civil Claims (Failed): This bill would have established a $5 million cap on general damages that an insurer and its insured are required to pay to any one claimant under a liability policy. The jury would not be informed of this cap, but courts must reduce any general damages award exceeding the limit. The bill clarified that it did not create a new cause of action or alter the types of recoverable damage under existing civil law.
HB 450—Evidentiary Presumption; Personal Injury (Enacted): This law requires individuals making a claim for damages to prove every element of their claim without relying on evidence that they were in good health prior to the incident. TDC Group supported the passage of this legislation.
HB 506/SB 156—Reproductive Health (Enacted): This law relates to in vitro fertilization procedures and provides healthcare providers and facilities with specific protection against criminal prosecution for actions taken in this area unless criminal negligence or general criminal intent can be proven. It specifically provides that all civil claims against a healthcare provider or facility related to in vitro fertilization are governed by Louisiana’s Medical Malpractice Act. TDC Group supported the passage of this legislation.
HB 113/SB 584—Noneconomic Damages Excluding Medical Liability Claims (Failed): These bills proposed to repeal Maryland’s general noneconomic damages cap and are a repeat of the bill we killed in 2024. TDC Group along with a large coalition of insurance, business, and healthcare interests advocated against the bills. Although they were heard in committee, they failed to advance.
HB 926/SB 681—Malpractice Claims and Healthcare Provider Definition (Failed): For purposes of medical liability claims, these bills proposed to amend the definition of “healthcare provider” to include an employee, agent, or contractor of a hospital. This legislation was introduced as a preemptive move to ensure they are covered by a noneconomic damages cap if the general cap is repealed. Although the bills were heard in committee, they failed to advance.
HB 1099—Punitive Damage Awards (Failed): This bill proposed to repeal Maryland’s long-standing high standard of actual malice for the award of punitive damages. It sought to lower the standard to ordinary gross negligence (implied malice) and allow punitive damages for “a failure to exercise even slight care” or “a pattern of repeated conduct.” The hook for public policy makers was that the bill included a 50 percent surcharge on punitive damage awards, payable to the state and to be dedicated to K-12 public education as part of the Blueprint for Maryland’s Future. TDC Group worked with a large coalition of insurance, business, and healthcare interests and advocated against the bill. While the bill was heard in committee, it failed to advance.
HB 68—Statue of Limitations (Failed): This bill proposed to reduce the timeframe for bringing a personal injury claim from five to two years. TDC Group advocated for the bill. The bill passed the House floor and Senate committees; however, it died when session adjourned.
HB 69—Collateral Source Rule (Failed): This bill proposed to amend the state’s collateral source rule. The bill allowed parties in actions seeking to recover for personal injury, bodily injury, or death to introduce evidence of the actual cost of medical care or treatment and if a defendant paid all or part of a plaintiff's special damages before trial, the plaintiff could not recover that portion from the defendant. The actual cost of medical care and discounts could be used as evidence for potential future treatment costs. The bill passed out of House committees but did not move in the Senate. TDC Group advocated for its passage; however, it died when the session adjourned.
HB 1184—Catastrophic Personal Injury (Failed): This bill proposed to modify the definition of catastrophic injury to include the loss of one or more limbs. TDC Group worked against the bill. It did not have a hearing and died when the session adjourned.
HB 195—Noneconomic Damages Cap (Enacted): After over a year of work by TDC Group and the coalition, this bill was signed into law. This bill changed the noneconomic damages cap in medical malpractices cases from $250,000 to $500,000 over five years with a two percent inflator thereafter. This effort was made in response to threats from personal injury lawyers to eliminate the cap at the ballot box and to declare the noneconomic damage cap unconstitutional in the courts.
HB 342—Standard of Care (Enacted): TDC Group worked with the healthcare coalition to draft this legislation that reverses an unfavorable court decision that established a heightened duty of care in medical malpractice cases when there is foreseeable catastrophic harm. This proposal successfully passed both chambers and was signed by the Governor.
HB 458—Physician Assistants (Enacted): TDC Group worked with the healthcare coalition in support of this bill to place physician assistants, for the first time, under the state’s cap on noneconomic damages in medical malpractice cases. It successfully passed out of both chambers and was signed by the Governor.
LB 205—Collateral Source (Failed): This proposal established guidelines for the admissibility of medical expense evidence in personal injury and wrongful death cases by limiting recoverable damages to amounts actually paid rather than billed. Also, the bill would have capped noneconomic damages at $1 million in lawsuits involving commercial motor vehicles requiring a commercial driver’s license. The bill was heard in committee and supported by the insurance trades; however, the bill died upon sine die.
HB 374; HB 378; HB 379; SB 176; SB 224—Tort Reforms (Failed): These proposals were designed to help the state’s medical liability tort climate. Since 2024, TDC Group has been working with the state medical association and other interested parties on this legislation, however, none of these bills have been enacted, despite a groundswell of physician activism and media coverage of the problem. TDC Group continues to work with the medical society and other parties to find solutions for our members and will participate in any interim work groups on these topics.
AB 1215—Patient Privacy Protection Act (Failed): This bill prohibited ex-parte interviews of the other party’s treating physician or other healthcare providers in personal injury claims. A version of the bill has been introduced since 2007 and has failed every year since. The bill was opposed through our insurance coalition and died in committee.
AB 2305/SB 1608—Noneconomic Damages Cap and Structured Settlements (Failed): These bills proposed to set a $250,000 cap for noneconomic damages in dental, medical, and podiatric malpractice actions and mandate a certificate of merit. In addition, awards for future pain and suffering in excess of $500,000 must be paid in a structured stream of payments. The bills died in committee and did not have hearings.
SB 3888/AB 5379—Determining Damages (Failed): These bills prohibited damages from being calculated using statistical tables unless agreed to by all parties and prohibited the reduction of damages in personal injury or wrongful death claims based on age, race, creed, color, national origin, citizenship or immigration status, sexual orientation, gender identity or expression, military status, sex, disability, genetic characteristics, familial or marital status, or status as a victim of domestic violence. TDC Group, our state coalition, and insurance trades advocated to amend the bill by removing troublesome provisions. It was heard in Senate Judiciary but died on the Senate floor as it did not move in the House.
SB 4225—Statute of Limitations (Failed): This bill would have reduced the statute of limitations for medical, dental, and podiatric malpractice claims from two-and-one-half years to one year if the defendant is a hospital. It died at the end of session without having a hearing.
SB 4423/AB 6063—Wrongful Death (Pending): The 2025 version of the Grieving Families Act expands the pool of beneficiaries and categories of recoverable damages in wrongful death claims. It is the same language that was vetoed in 2024. The proposal passed both bodies. Our coalition is working to secure a veto, as we have successfully done in the past three years.
SB 5005—Data Breach Private Right of Action (Failed): This bill proposed to create a private right of action for the breach of a consumer's identifying information such as their social security number, driver's license number, bank account number, credit or debit card number, personal identification number, automated or electronic signature, unique biometric data, account passwords, or other information that can be used to access an individual's financial accounts or to obtain goods and services. It died at the end of session without having a hearing.
HB 805—Gender-Affirming Care (Enacted): The leadership of both chambers used a last-minute floor amendment on an unrelated bill to legislate the removal of gender-affirming care medical liability actions from the state’s cap on noneconomic damages and increase the statute of limitations for such actions to 10 years from discovery. TDC Group opposed this bill because it increased liability for healthcare providers.
HB 1349—Noneconomic Damages Cap (Failed): This bill failed on the floor of the first chamber. TDC Group advocated through a coalition in opposition to this legislation that would have increased the cap on noneconomic damages from $500,000 to $3 million.
HB 447—Noneconomic Damages Cap (Pending): TDC Group is advocating against and activating a coalition to fight legislation that would raise the noneconomic damages caps and eliminate the catastrophic injuries noneconomic damages cap. We expect it to start moving in early 2026.
SB 453—Noneconomic Damages (Enacted): This law reinstated the state’s cap on noneconomic damages, which was held unconstitutional by the state supreme court and raises the limit from its previous amount of $350,000 to $500,000. The legislation applies to claims filed after September 1, 2025. However, other than raising the cap to $500,000, the new law made no other substantial changes to the law that was overturned by the state Supreme Court in 2019. The enactment of this law is an attempt to get the law back in front of the Supreme Court in hopes of a favorable ruling.
SB 1049—Wrongful Life (Failed): This legislation would have created a private right of action against healthcare providers for gender transition healthcare services provided to minors and specifically stated that there was no statute of limitations on these types of actions. This bill did not pass prior to the required crossover date and failed.
SB 1065—Noneconomic Damages (Failed): This bill would have reinstated the state’s cap on noneconomic damages, which was previously held unconstitutional by the state Supreme Court and raised the limit from its previous amount of $350,000 to $500,000. It would have applied the cap to wrongful death cases, too. This legislation made it out of the Senate, but it never made it out of the House and failed.
SB 233—Statute of Repose (Failed): This bill would have changed the statute of repose for healthcare injury claims from its current five-year limitation to ten years from the date of the treatment, omission, or operation that caused the injury. It applied retroactively to claims for which legal action had not yet been initiated. TDC Group led the fight to oppose this legislation and based on our sole efforts, this legislation was defeated.
SB 340—Certificate of Merit (Pending): This bill would create a Certificate of Merit requirement in medical malpractice cases and clarifies that the expert who provides the certificate and testimony at trial must be currently practicing in the same specialty or subspecialty of the provider that is being sued for malpractice. TDC Group is a member of the state civil justice coalition, who is supporting this bill, which is awaiting its first hearing in committee.
HB 5661—Wrongful Death Statute of Limitations (Failed): This bill would have expanded the statute of limitations in wrongful death actions to ten years for cases involving the death of a child in utero or within six months of birth. TDC Group worked with our trade association to successfully oppose this bill. The bill was never heard in committee before the legislature adjourned for the year.
HB 5903/HB 5912—Collateral Source Rule Repeal (Failed): These two bills proposed to repealed the requirement that third-party payments reduce damages in medical malpractice cases and required that the billed amount of medical damages be awarded. Currently, the rules permit the introduction of evidence that the plaintiff does not owe the billed amount of damages and require a reduction of third-party payments. TDC Group worked with the medical, hospital, and industry associations to successfully oppose these bills. Both bills were not heard in committee before the legislature adjourned for the year.
SB 244—Tort Reform (Failed): This legislation would have improved the South Carolina tort climate by adopting a modified comparative fault system. If the plaintiff was found to be more than 50 percent at fault, it would result in a defense verdict. If the plaintiff was not more than 50 percent at fault, damages would be divided among the defendants according to the defendants’ percentage of fault. The bill would have redefined the word “occurrence” in medical liability claims to mean “an unfolding sequence of events which proximately flow from a single act of negligence including continuous or repeated exposure to substantially the same harmful conditions. For purposes of this section, multiple events occurring without a break in the causal chain that result in substantially the same damages shall be considered one occurrence.” Finally, the current medical liability cap in South Carolina contains an exception for gross negligence or wanton or willful or reckless conduct. This bill would have changed this exception to apply where the defendant: (1) had an intent to harm and did in fact harm the claimant; (2) had pled guilty to or been convicted of a felony arising out of the same act or course of conduct complained of by the plaintiff and that the act or course of conduct was a proximate cause of the plaintiff's damages; or (3) acted or failed to act while under the influence of alcohol, drugs that are not otherwise lawfully prescribed and administered in accordance with a valid prescription, or any intentionally consumed glue, aerosol, or other toxic vapor to the degree that his judgment was materially and appreciably impaired. This legislation was fiercely debated, and while this legislation didn’t pass, pieces were amended into other bills.
HB 3430—Tort Reform (Enacted): While this law deals mostly with liquor liability issues, a section from SB 244 deals with comparative fault and was amended into this bill. The law modifies the state’s rules on comparative negligence, prohibits the application of joint and several liability in certain circumstances, and in some cases allows for apportionment of liability to non-party defendants.
HB 5/SB 419—Damage Caps (Failed): These bills would have increased the cap on damages raising the limit from $750,000 to $1.5 million for an injured plaintiff in routine civil actions, and from $1 million to $2 million for actions relating to catastrophic injury or loss. TDC Group worked with a coalition to oppose this legislation.
HB 4/SB 418—Government Tort Liability Act (Failed): These bills would have increased minimum liability limits under governmental tort liability and set minimum coverage at $750,000 for bodily injury or death of a single individual and $1.5 million for multiple individuals in a single incident. TDC Group worked with other interested parties to successfully oppose this legislation.
HB 1123/SB 800—Tort Liability (Failed): These bills would have increased the amount of medical, hospital, or doctor bills that are presumed in a civil action to have been necessary and reasonable if the bills are itemized in the complaint or civil warrant with a copy of the bills attached as an exhibit to the complaint or civil warrant, from a total of $4,000 to a total of $25,000. TDC Group worked with a coalition to successfully defeat this bill.
HB 1419—Civil Liability Damage Caps (Failed): This bill proposed that in action on a personal injury claim, the civil liability to a claimant for noneconomic damages, unless limited by other law, may not exceed three times the amount awarded to the claimant as damages for past and future healthcare expenses and for noneconomic damages awarded as damages for past and future physical pain and suffering, and $1 million if the claim arises from an event primarily causing emotional injury to the claimant, and $250,000 if the claim arises from an event primarily causing bodily injury to the claimant for noneconomic damages awarded as damages for past and future mental or emotional pain or anguish. This bill was not specific to medical liability claims but the concern was that an equal protection argument would be promoted to raise the cap on damages in medical liability claims. TDC Group worked to defeat this bill.
HB 2072—Advance Directives (Failed): This legislation proposed that a healthcare provider who violated the Texas Advance Directive Act relating to withdrawing or withholding life-sustaining treatment from a patient would be guilty of a first-degree felony (punishable by 5 to 99 years in prison). It further proposed that there would be no statute of limitations for such claims. TDC Group successfully worked with TAPA and other interested parties to defeat this legislation.
HB 4036—Limits in a Healthcare Liability Claim (Failed): This bill would have applied a retroactive annual CPI adjustment to the state’s cap on noneconomic damages back to 2003, with a continuing CPI adjustment moving into the future. TDC Group worked with TAPA and national trade organizations to oppose or amend this bill.
HB 4327—Wrongful Death (Failed): This legislation would have allowed siblings of a deceased individual to file a wrongful death action. TDC Group worked with TAPA and other parties to oppose this legislation.
HB 288—Noneconomic Damage Caps (Failed): This legislation would have doubled the statute of limitations and ultimate statute of repose, changed what evidence is admissible regarding collateral sources, and more than doubled the noneconomic damage cap for medical malpractice claims. TDC Group successfully advocated to defeat this legislation.
HB 503—Medical Liability Damages (Enacted): This law maintained the state’s $450,000 cap on noneconomic damages and reinstated an annual inflation adjustment based on CPI. It implements an anti-anchoring provision; a truth in damages provision; a provision protecting a healthcare provider’s personal assets from a judgment by a plaintiff unless the provider acted in a willful, malicious, or deliberately fraudulent manner (protection under this provision requires the healthcare provider to maintain a $1 million liability policy); and a provision that would allow defendants to collect attorneys’ fees in specific instances. In addition, it changes the pre-litigation review panel process. TDC Group worked with other interested parties to support HB 503, which was signed into law.
HB 427—Noneconomic Damage Limits; Screening Panels (Failed): This bill would have introduced noneconomic damages limits in medical malpractice actions by setting the limit at $250,000 per claimant if the defendant is a natural person and $500,000 per claimant and $250,000 per defendant if the defendant is not a natural person. In a medical malpractice action involving wrongful death, the total damages awarded would have been limited to $500,000 per claimant. Punitive damages were limited to $200,000 or twice the total economic and noneconomic damages, whichever was greater. In addition to damage caps, the bill created medical review panels. TDC Group worked with our trade association to support this bill. This bill failed to move forward before the legislature adjourned.
SB 1152—Nursing Home Insurance Limits (Enacted): TDC Group successfully negotiated an acceptable compromise that would increase the general liability insurance requirement for nursing homes and prohibit these policies from having eroding limits. This bill passed both chambers of the legislature and was signed by the Governor.
HB 1730—Strict Liability (Enacted): TDC Group worked with the state hospital association to improve harmful language in this law that would have created healthcare employer strict liability for the tortious acts of an employee. It passed both chambers of the legislature and was amended by the Governor. The legislature rejected the Governor’s amendments. Ultimately, the Governor signed the bill into law.
HB 1507—Nondisclosure Agreements (Failed): TDC Group worked with a coalition to lobby and kill this bill in committee. The proposal would have voided nondisclosure and non-disparagement provisions in settlement agreements between a patient and healthcare provider retroactively for one year and going forward from the date of enactment. This included a minimum of $10,000 in statutory damages for failure to notify patients who entered into such agreements.
HB 2212—Limiting Medical Liability Insurance (Failed): This bill would have eliminated the statute of limitations in medical professional liability cases for abortions with certain exceptions. TDC Group worked with the state medical and hospital association to oppose this bill. The legislature adjourned for the year without moving the bill forward.
HB 2809—Medical Liability Statute of Limitations (Failed): This bill proposed to extend the statute of limitations for minor patients or their parent or guardian to file an action for medical liability to within 5 years of age 18. Currently, the limitation is within 2 years of the date of injury or prior to the minor’s 12th TDC Group worked with the medical association to oppose this bill. The legislature adjourned for the year without moving the bill forward.
©2025 The Doctors Company. This document is Proprietary. The information contained in this document is not intended to be and does not constitute legal advice; instead, all information, content, and material are for general information purposes only. This is not an exhaustive list of laws and regulations applicable to this subject matter; others may apply.
