The campaign has prompted a ferocious fight between doctors and attorneys over the rights of injured patients with more than $102 million spent in one of the state's most expensive ballot initiatives. Doctors, hospitals and medical liability insurers say raising the cap would drive up medical costs, force doctors out of state and reduce access to medical care. According to the California Medical Association, the average doctor in the state paid $26,511 last year in premiums compared to $99,290 in Connecticut and $137,412 in New York, two states without caps. In 2009, the Congressional Budget Office concluded that limiting liability would lead to savings of 0.5 percent to 1 percent on health care spending, a negligible amount because so many states already have caps. Other caps, including California, have been upheld. Since Texas set a limit at $750,000 in 2003, more doctors are practicing in emergency rooms and the state is attracting doctors from states without caps, said Jon Opelt, executive director for Texas Alliance For Patient Access, which represents health providers.