The United States has experienced three medical malpractice (med mal) crises in the past 40 years. In response, 31 states now have caps on noneconomic or total damages. Researchers have studied the impact of these caps, relative to control states without caps, but have not studied trends in no-cap states or overall national trends. We find that the per-physician rate of paid med mal claims has been dropping for 20 years and in 2012 was less than half the 1992 level. Lawsuit rates, in the states with...