California set the national standard for malpractice reform by adopting the Medical Injury Compensation Reform Act (MICRA) four decades ago, helping lead reform in many other states over the years. Trial attorneys have worked tirelessly since adoption to undermine the law, both in the courts and state legislature. In 2013 the trial attorneys adopted a new strategy to undermine MICRA, seeking changes through a ballot referendum, Proposition 46. This effort was preceded by a sustained campaign in major state newspapers attempting to undermine the respectability of physicians. This threat was unlike any other since MICRA's adoption. The collective medical industry had focused resources on legislative and legal arenas, so taking the decision to voters removed many of the advantages in candidate education built up over many years. The threat extended beyond California, as the trial attorneys and their strategists made it clear they would use this strategy as a model across the country if successful. Defending malpractice reforms in one state become a necessity for the entire nation.

CMA was the recipient of the 2015 Profiles of Excellence Award in the Advocacy category for this initiative. CMA and their component societies were also honored with the 2015 President’s Award recognizing their collaborative efforts in the campaign.