Lebron v. Gottlieb Memorial Hospital

930 N.E.2d 895, 237 Ill. 2d 217, 341 Ill. Dec. 381, 2010 Ill. LEXIS 26

Opinions

CHIEF JUSTICE FITZGERALD

delivered the judgment of the court, with opinion.

Justices Freeman, Kilbride and Burke concurred in the judgment and opinion.

Justice Karmeier concurred in part and dissented in part, with opinion, joined by Justice Garman.

Justice Thomas took no part in the decision.

OPINION

At issue in this appeal is the constitutionality of section 2 — 1706.5 of the Code of Civil Procedure (Code) (735 ILCS 5/2 — 1706.5 (West 2008)), which was adopted as part of Public Act 94 — 677 (Act) (see Pub. Act 94 — 677, §330, eff. August 25, 2005). Section 2 — 1706.5 sets certain caps on noneconomic damages in medical malpractice cases. Relying on this court’s decision in Best v. Taylor Machine Works, 179 Ill. 2d 367 (1997), the circuit court of Cook County ruled that the statutory caps violate the separation of powers clause of the Illinois Constitution (Ill. Const. 1970, art. II, §1) and declared the entire Act invalid, pursuant to its inseverability provision (Pub. Act 94 — 677, §995, eff. August 25, 2005).

For the reasons discussed below, we affirm in part and reverse in part the judgment of the circuit court, and remand this matter for further proceedings.

BACKGROUND

In November 2006, plaintiffs Abigaile Lebrón (Abigaile), a minor, and her mother, Frances Lebrón (Lebrón), filed a medical malpractice and declaratory judgment action in the Cook County circuit court against defendants Gottlieb Memorial Hospital, Roberto Levi-D’Ancona, M.D., and Florence Martinoz, R.N. According to the five-count amended complaint, Lebrón was under the care of Dr. Levi-D’Ancona during her pregnancy. On October 31, 2005, Lebrón was admitted to Gottlieb, where Dr. Levi-D’Ancona delivered Abigaile by Caesarean section. Martinoz assisted in the delivery and provided the principal nursing care from the time of Lebron’s admission. In counts I through IY plaintiffs alleged that as the direct and proximate result of certain acts and omissions by defendants, Abigaile sustained numerous permanent injuries including, but not limited to, “severe brain injury, cerebral palsy, cognitive mental impairment, inability to be fed normally such that she must be fed by a gastronomy tube, and inability to develop normal neurological function.”

In count Y relevant to this appeal, plaintiffs sought a judicial determination of their rights with respect to Public Act 94 — 677 and a declaration that certain provisions of the Act, applicable to plaintiffs’ cause of action, violate the Illinois Constitution. Although plaintiffs challenged several provisions of the Act, at issue here is plaintiffs’ challenge to the caps on noneconomic damages set forth in section 2 — 1706.5 of the Code.¹ Plaintiffs alleged that Abigaile “has sustained disability, disfigurement, pain and suffering to the extent that damages for those injuries will greatly exceed the applicable limitations on noneconomic damages under Public Act 94— 677.” Citing Best, plaintiffs alleged that the limitation on damages violates the separation of powers clause of the Illinois Constitution (Ill. Const. 1970, art. II, §1) by permitting the General Assembly to supplant the judiciary’s authority in determining whether a remittitur is appropriate under the facts of the case. Again citing to Best, plaintiffs further alleged that the limitation on noneconomic damages constitutes improper special legislation (Ill. Const. 1970, art. PV¡ §13) in that “the restrictions on noneconomic damages grant limited liability specially and without just cause to a select group of health care providers].” Plaintiffs additionally alleged that the damages caps violate Abigaile’s right to a trial by jury (Ill. Const. 1970, art. I, §13), due process (Ill. Const. 1970, art. I, §2), equal protection (Ill. Const. 1970, art. I, §2), and a certain and complete remedy (Ill. Const. 1970, art. I, §12).²

Plaintiffs filed a motion for partial judgment on the pleadings as to count V, and Gottlieb and Martinoz countered with a motion for partial summary judgment on count V. Dr. Levi-D’Ancona moved for judgment on the pleadings as to his counterclaim seeking a declaration that the challenged statutory provisions do not violate the Illinois Constitution. After briefing and oral argument, the circuit court granted plaintiffs’ motion for partial judgment on the pleadings, and denied Dr. Levi-D’Ancona’s motion for judgment on the pleadings as to his counterclaim to the extent it sought a declaration that the damages caps are consistent with the separation of powers clause. The circuit court did not expressly deny the motion for partial summary judgment as to count V filed by Gottlieb and Martinoz.

The circuit court determined that the statutory cap on noneconomic damages in section 2 — 1706.5, like the statutory damages cap at issue in Best, operates as a legislative remittitur in violation of the separation of powers clause of the Illinois Constitution (Ill. Const. 1970, art. II, §1). Based on the Act’s inseverability provision (Pub. Act 94 — 677, §995, eff. August 25, 2005), the circuit court invalidated the Act in its entirety. The circuit court declined to consider plaintiffs’ other constitutional challenges to the Act. The circuit court later amended its order to add the findings required by Supreme Court Rule 18 (210 Ill. 2d R. 18) and, on the motion of Gottlieb and Martinoz, made a Rule 304(a) finding of appealability (210 Ill. 2d R. 304(a)).

Pursuant to Supreme Court Rule 302(a) (210 Ill. 2d R. 302(a)), Gottlieb and Martinoz, and Dr. Levi-D’Ancona, filed appeals directly with this court. We consolidated these appeals for review, and allowed the Illinois Attorney General to intervene to defend the constitutionality of the Act. See 210 Ill. 2d R. 19. We also allowed numerous individuals and organizations to file briefs amicus curiae. See 210 Ill. 2d R. 345.³

ANALYSIS

I

This case comes to us following the grant of plaintiffs’ motion for judgment on the pleadings. See 735 ILCS 5/2 — 615(e) (West 2008). “ ‘[A] motion for judgment on the pleadings is like a motion for summary judgment limited to the pleadings.’ ” Employers Insurance of Wausau v. Ehlco Liquidating Trust, 186 Ill. 2d 127, 138 (1999), quoting 3 R. Michael, Illinois Practice §27.2, at 494 (1989), citing Tompkins v. France, 21 Ill. App. 2d 227 (1959). Judgment on the pleadings is proper if the pleadings disclose no genuine issue of material fact and that the movant is entitled to judgment as a matter of law. M.A.K. v. Rush-Presbyterian-St. Luke’s Medical Center, 198 Ill. 2d 249, 255 (2001); Employers Insurance of Wausau, 186 Ill. 2d at 138. We review the grant of judgment on the pleadings de novo. Gillen v. State Farm Mutual Automobile Insurance Co., 215 Ill. 2d 381, 385 (2005).

De novo review is also appropriate because the circuit court’s grant of judgment on the pleadings rests on its determination that section 2 — 1706.5 of the Code violates the Illinois Constitution. Whether a statute is unconstitutional is a question of law subject to de novo review. People v. Johnson, 225 Ill. 2d 573, 584 (2007). We are mindful that section 2 — 1796.5, like every statute, enjoys a strong presumption of constitutionality and that the burden of rebutting this presumption rests with the party challenging the statute — here, plaintiffs. In re Marriage of Miller, 227 Ill. 2d 185, 195 (2007); In re Estate of Jolliff, 199 Ill. 2d 510, 517 (2002).

The circuit court ruled that section 2 — 1706.5 is unconstitutional both on its face and as applied to plaintiffs. A statute is facially invalid only if no set of circumstances exists under which the statute would be valid. Napleton v. Village of Hinsdale, 229 Ill. 2d 296, 306 (2008). Therefore, the circuit court’s ruling that the statute is facially invalid negates any notion that the statute could be validly applied to these plaintiffs and the court’s “as applied” ruling was unnecessary. Moreover, when there has been no evidentiary hearing and no findings of fact, the constitutional challenge must be facial. In re Parentage of John M., 212 Ill. 2d 253, 268 (2004), citing Reno v. Flores, 507 U.S. 292, 300-01, 123 L. Ed. 2d 1, 15-16, 113 S. Ct. 1439, 1446 (1993). Accordingly, we reverse the circuit court’s “as applied” ruling and limit our review to whether section 2 — 1706.5 is facially invalid. See John M., 212 Ill. 2d at 268. We turn now to the statute, itself.

Section 2 — 1706.5 provides in relevant part:

“(a) In any medical malpractice action or wrongful death action based on medical malpractice in which economic and non-economic damages may be awarded, the following standards shall apply:

(1) In a case of an award against a hospital and its personnel or hospital affiliates, as defined in Section 10.8 of the Hospital Licensing Act, the total amount of non-economic damages shall not exceed $1,000,000 awarded to all plaintiffs in any civil action arising out of the care.

(2) In a case of an award against a physician and the physician’s business or corporate entity and personnel or health care professional, the total amount of non-economic damages shall not exceed $500,000 awarded to all plaintiffs in any civil action arising out of the care.

(3) In awarding damages in a medical malpractice case, the finder of fact shall render verdicts with a specific award of damages for economic loss, if any, and a specific award of damages for non-economic loss, if any.

The trier of fact shall not be informed of the provisions of items (1) and (2) of this subsection (a).” 735 ILCS 5/2— 1706.5 (West 2008).

The limitation on noneconomic damages set forth in section 2 — 1706.5 is one of several “significant reforms” to the civil justice system the General Assembly adopted in response to a “health-care crisis” in this state. Pub. Act 94 — 677, §101(4), eff. August 25, 2005. According to the legislative findings set forth in the Act, the rising cost of medical liability insurance increases the financial burdens on physicians and hospitals and is believed to have contributed to a reduction of available medical care in portions of Illinois. Pub. Act 94 — 677, §§101(1), (2), eff. August 25, 2005. The General Assembly determined:

“[T]he current medical malpractice situation requires reforms that enhance the State’s oversight of physicians and ability to discipline physicians, that increase the State’s oversight of medical liability insurance carriers, that reduce the number of nonmeritorious healing art malpractice actions, that limit non-economic damages in healing art malpractice actions, that encourage physicians to provide voluntary services at free medical clinics, that encourage physicians and hospitals to continue providing health care services in Illinois, and that encourage physicians to practice in medical care shortage areas.” Pub. Act 94 — 677, §101(5), eff. August 25, 2005.

In addition to the caps on noneconomic damages, the reforms adopted by the legislature included changes to the Illinois Insurance Code (Pub. Act 94 — 677, §310, eff. August 25, 2005), the Medical Practice Act of 1987 (Pub. Act 94 — 677, §315, eff. August 25, 2005), and the Good Samaritan Act (Pub. Act 94 — 677, §340, eff. August 25, 2005), as well as other changes to the Code (Pub. Act 94 — 677, §330, eff. August 25, 2005), and new legislation known as the “Sorry Works! Pilot Program Act” (Pub. Act 94 — 677, art. 4, eff. August 25, 2005). We need not delve into the details of these reforms because the focus of this appeal is one particular reform: the limitation on noneconomic damages codified in section 2 — 1706.5.

The circuit court invalidated the statute for the sole reason that, pursuant to our decision in Best, the limitation on noneconomic damages in section 2 — 1706.5 violates the separation of powers clause of the Illinois Constitution (Ill. Const. 1970, art. II, §1). Defendants argue that the statute at issue in Best is distinguishable from the present statute and that the circuit court’s ruling represents an unjustified expansion of Best. Defendants maintain that the damages provision in section 2 — 1706.5 constitutes a valid exercise of the General Assembly’s police power in response to a public threat, as reflected in the legislative findings, and that under our precedents, the statute does not offend separation of powers principles. Plaintiffs continue to argue that Best is controlling and that neither this court’s precedents, nor the legislative findings on which defendants rely, can save the statute. We consider the Best decision in detail.

In Best, this court considered constitutional challenges to several provisions of Public Act 89 — 7, commonly referred to as the Tort Reform Act of 1995 or the Civil Justice Reform Amendments of 1995. Pub. Act 89 — 7, eff. March 9, 1995. Among the challenged provisions was a $500,000 cap on noneconomic damages. Codified at section 2 — 1115.1(a) of the Code, this provision stated:

“In all common law, statutory or other actions that seek damages on account of death, bodily injury, or physical damage to property based on negligence, or product liability based on any theory or doctrine, recovery of non-economic damages shall be limited to $500,000 per plaintiff. There shall be no recovery for hedonic damages.” 735 ILCS 5/2 — 1115.1(a) (West 1996).

The statute defined “non-economic damages” as “damages which are intangible, including but not limited to damages for pain and suffering, disability, disfigurement, loss of consortium, and loss of society.” 735 ILCS 5/2— 1115.2(b) (West 1996). The statute defined “economic damages,” which were not capped, as “all damages which are tangible, such as damages for past and future medical expenses, loss of income or earnings and other property loss.” 735 ILCS 5/2 — 1115.2(a) (West 1996). The sum of noneconomic and economic damages constituted “compensatory damages.” 735 ILCS 5/2 — 1115.2(c) (West 1996). Thus, damages which were intended to make a person whole were limited by section 2 — 1115.1. Best, 179 Ill. 2d at 384.

Before considering the specific constitutional challenges to this provision, we noted that the cap on noneconomic damages was supported by several legislative findings which, as we later recognized, were entitled to “great deference.” Best, 179 Ill. 2d at 389. These findings declared that:

“(1) limiting noneconomic damages will improve health care in rural Illinois, (2) more than 20 states limit noneconomic damages, (3) the cost of health care has decreased in those states, (4) noneconomic losses have no monetary dimension, and no objective criteria or jurisprudence exists for assessing or reviewing noneconomic damages awards, (5) such awards are highly erratic and depend on subjective preferences of the trier of fact, (6) highly erratic noneconomic damages awards subvert the credibility of such awards and undercut the deterrent function of tort law, (7) such awards must be limited to provide consistency and stability for all parties and society and (8) *** limiting noneconomic damages was the most effective step toward legislative reform of tort law because it reduces litigation costs and expedites settlement.” Best, 179 Ill. 2d at 385.

We further noted that the preamble to Public Act 89 — 7 identified several “purposes” of the damages cap: reducing the cost of health care, increasing accessibility to health care, promoting consistency in awards, reestablishing the credibility of the civil justice system, establishing parameters for noneconomic damages, protecting the economic health of the state by decreasing systemic costs, and ensuring the affordability of insurance. Best, 179 Ill. 2d at 385.

Proceeding from the premise that our task was to determine the constitutionality of the statute, and not its wisdom (Best, 179 Ill. 2d at 390), we first considered the plaintiffs’ special legislation challenge (Ill. Const. 1970, art. W, §13). We observed that the purpose of the special legislation clause “is to prevent arbitrary legislative classifications that discriminate in favor of a select group without a sound, reasonable basis.” Best, 179 Ill. 2d at 391. The plaintiffs argued that the statute impermissibly penalized the most severely injured persons whose award for noneconomic damages would likely exceed $500,000, but for the statutory cap, and that the statute arbitrarily benefitted certain tortfeasors by relieving them of liability for fully compensating injured persons. The plaintiffs relied on Wright v. Central Du Page Hospital Ass’n, 63 Ill. 2d 313 (1976) (holding that a $500,000 limit on compensatory damages in medical malpractice actions was arbitrary and violated the special legislation clause), Grace v. Howlett, 51 Ill. 2d 478 (1972) (holding that a statute that limited recovery for certain automobile accident victims was an arbitrary and unreasonable classification in violation of the special legislation clause), and Grasse v. Dealer’s Transport Co., 412 Ill. 179 (1952) (holding that a workers’ compensation provision violated the special legislation clause by creating unreasonable classifications in which the plaintiffs ability to recover complete compensation was determined by fortuitous events).

We agreed with the plaintiffs that under Wright, Grace and Grasse the automatic $500,000 limit on noneconomic damages was arbitrary and violated the special legislation clause. Best, 179 Ill. 2d at 406. Although agreeing with the defendants that noneconomic injuries are difficult to assess, we determined that such difficulty was not alleviated by imposing an arbitrary damages limitation in all cases, without regard to the facts or circumstances. Best, 179 Ill. 2d at 406. Indeed, we determined that the damages limitation actually undermined the statute’s stated goal of providing consistency and rationality to the civil justice system. Best, 179 Ill. 2d at 406. We also rejected the defendants’ argument that the legislature’s interest in reducing the systemic costs of tort liability was sufficient to overcome the plaintiffs’ special legislation challenge, noting that the entire burden of any cost savings would impermissibly rest on one class of injured plaintiffs. Best, 179 Ill. 2d at 407.

We continued our analysis of section 2 — 1115.1 by considering the plaintiffs’ argument that section 2 — 1115.1 also violated the separation of powers clause (Ill. Const. 1970, art. II, §1). The plaintiffs argued that the statute invaded the province of the judiciary to assess, on a case-by-case basis, whether a jury’s award is excessive, by imposing a one-size-fits-all legislative remittitur. The defendants countered that the statutory cap simply set an outer parameter by which subjective damages were limited and did not displace traditional judicial functions.

We explained that the purpose of the separation of powers clause “ ‘is to ensure that the whole power of two or more branches of government shall not reside in the same hands.’ ” Best, 179 Ill. 2d at 410, quoting People v. Walker, 119 Ill. 2d 465, 473 (1988). “Each branch of government has its own unique sphere of authority that cannot be exercised by another branch.” Best, 179 Ill. 2d at 410. Thus, “the legislature is prohibited from enacting laws that unduly infringe upon the inherent powers of judges.” Best, 179 Ill. 2d at 411. Though recognizing that the separation between the three branches of government is “not absolute and unyielding” and may “overlap,” we emphasized that the determination of whether a statute violates the separation of powers clause rests with the judiciary. Best, 179 Ill. 2d at 411.

We also reviewed the doctrine of remittitur, which has long been recognized as a part of Illinois law. Best, 179 Ill. 2d at 412. We noted that, for over a century, application of this doctrine has been a traditional and inherent power of the judicial branch, to be exercised in appropriate circumstances to correct an excessive jury verdict, and that its application presents a question of law for the court. Best, 179 Ill. 2d at 411-12. Where a jury verdict “ ‘falls outside the range of fair and reasonable compensation or results from passion or prejudice, or if it is so large that it shocks the judicial conscience,’ ” a court has a duty to correct the verdict by ordering a remittitur, with the plaintiff’s consent. Best, 179 Ill. 2d at 412, quoting Richardson v. Chapman, 175 Ill. 2d 98, 113 (1997). If consent is not given, the court has a duty to order a new trial. Best, 179 Ill. 2d at 413. Whether a remittitur should be ordered is necessarily considered on a case-by-case basis. That is, the court must carefully examine the particular evidence and circumstances of the case to determine whether it must override the jury’s verdict. Best, 179 Ill. 2d at 413.

In Best, we concluded that, although the legislature may limit certain types of damages, such as damages recoverable in statutory causes of action (Best, 179 Ill. 2d at 415), the limitation on damages in section 2 — 1115.1 violated the separation of powers clause:

“[S]ection 2 — 1115.1 undercuts the power, and obligation, of the judiciary to reduce excessive verdicts. In our view, section 2 — 1115.1 functions as a ‘legislative remittitur.’ Unlike the traditional remittitur power of the judiciary, the legislative remittitur of section 2 — 1115.1 disregards the jury’s careful deliberative process in determining damages that will fairly compensate injured plaintiffs who have proven their causes of action. The cap on damages is mandatory and operates wholly apart from the specific circumstances of a particular plaintiff’s noneconomic injuries. Therefore, section 2 — 1115.1 unduly encroaches upon the fundamentally judicial prerogative of determining whether a jury’s assessment of damages is excessive within the meaning of the law.” Best, 179 Ill. 2d at 413-14.

We also concluded that section 2 — 1115.1 unduly expanded the remittitur doctrine by forcing a successful plaintiff to forgo part of the jury award, “in clear violation of the well-settled principle that a trial court does not have authority to reduce a damages award by entry of a remittitur if the plaintiff objects or does not consent.” Best, 179 Ill. 2d at 414.

After considering constitutional challenges to other portions of Public Act 89 — 7 and invalidating several provisions (Best, 179 Ill. 2d at 459), we ultimately held the act void in its entirety (Best, 179 Ill. 2d at 467). We concluded that what remained of Public Act 89 — 7 could not be independently enforced. Best, 179 Ill. 2d at 467. In the course of our analysis, we noted that the General Assembly considered the cap on noneconomic damages essential to the tort reform scheme. Best, 179 Ill. 2d at 465.

Before turning to the parties’ arguments regarding the applicability of Best to the present litigation, we consider defendants’ contention that the separation of powers analysis in Best was unnecessary to the disposition of that case and is therefore dicta entitled to little weight. See Best, 179 Ill. 2d at 471 (Bilandic, J., specially concurring) (declining to join the separation of powers analysis because it was “wholly unnecessary and constitutes dicta'”)-, Best 179 Ill. 2d at 481 (Miller, J., concurring in part and dissenting in part) (stating that the separation of powers analysis “is entirely unnecessary, given the majority’s prior holding that the same measure is invalid special legislation”).

We agree that the separation of powers analysis in Best was not necessary to our decision. The court had already determined that section 2 — 1115.1 violated the special legislation clause; a further reason for finding the statute unconstitutional was not required. We disagree, however, that our opinion on this matter is mere dicta entitled to little weight. As this court has explained, dictum is of two types: obiter dictum and judicial dictum. People v. Williams, 204 Ill. 2d 191, 206 (2003). “Obiter dictum,” frequently referred to as simply “dictum,” is a remark or opinion that a court uttered as an aside. Exelon Corp. v. Department of Revenue, 234 Ill. 2d 266, 277 (2009); Cates v. Cates, 156 Ill. 2d 76, 80 (1993). Obiter dictum is not essential to the outcome of the case, is not an integral part of the opinion, and is generally not binding authority or precedent within the stare decisis rule. Exelon, 234 Ill. 2d at 277. “In contrast, ‘an expression of opinion upon a point in a case argued by counsel and deliberately passed upon by the court, though not essential to the disposition of the cause, if dictum, is a judicial dictum. [Citation.] *** [A] judicial dictum is entitled to much weight, and should be followed unless found to be erroneous.’ (Emphasis added.)” Exelon, 234 Ill. 2d at 277-78, quoting Cates, 156 Ill. 2d at 80. See also Woods v. Interstate Realty Co., 337 U.S. 535, 537, 93 L. Ed. 1524, 1526, 69 S. Ct. 1235, 1237 (1949) (“where a decision rests on two or more grounds, none can be relegated to the category of obiter dictum”).

Although the separation of powers discussion in Best was not essential to our disposition, the issue was briefed by the parties and “deliberately passed upon” by this court. Our analysis, summarized above, examined the nature of the separation of powers doctrine and the interplay between the three branches of government; the contours of the remittitur doctrine and its place in Illinois law; and the effect of the statutory cap on the trial court’s inherent authority to correct excessive verdicts. Further, our conclusion was expressed as a holding. Best, 179 Ill. 2d at 415; see also Unzicker v. Kraft Food Ingredients Corp., 203 Ill. 2d 64, 93 (2002) (stating that in Best, we “held” that section 2 — 1115.1 of the Code was an unconstitutional legislative remittitur). Our opinion on this matter can hardly be considered an “aside” and, if a dictum, is a judicial dictum. Accordingly, it is entitled to much weight and should be followed unless found to be erroneous. See Exelon, 234 Ill. 2d at 278.

Defendants do not argue that the separation of powers analysis in Best is necessarily erroneous. Rather, they argue that the statute at issue here, section 2 — 1706.5, is distinguishable from the statute invalidated in Best, section 2 — 1115.1. Defendants maintain that while section 2 — 1115.1 was part of a broad-based effort to reduce systemwide litigation costs, section 2 — 1706.5 is narrowly tailored to address a specific issue: the health-care crisis. Based on this distinction, defendants argue that Best is not controlling and section 2 — 1706.5 does not unduly encroach upon the judiciary.

We agree with defendants that the scope of the statute at issue in Best was much broader than the statute we examine here. The damages cap in section 2 — 1115.1 applied to all actions, whether based on the common law or statute, that sought damages “on account of death, bodily injury, or physical damage to property based on negligence, or product liability based on any theory or doctrine.” 735 ILCS 5/2 — 1115.1(a) (West 1996). In contrast, the damages cap in section 2 — 1706.5 applies to “any medical malpractice action or wrongful death action based on medical malpractice.” 735 ILCS 5/2 — 1706.5(a) (West 2008). Notwithstanding this difference, the encroachment upon the inherent power of the judiciary is the same in the instant case as it was in Best.

Under section 2 — 1706.5, the court is required to override the jury’s deliberative process and reduce any noneconomic damages in excess of the statutory cap, irrespective of the particular facts and circumstances, and without the plaintiff’s consent. Section 2 — 1706.5 thus violates the separation of powers clause because it “unduly encroaches upon the fundamentally judicial prerogative of determining whether a jury’s assessment of damages is excessive within the meaning of the law.” Best, 179 Ill. 2d at 414. Section 2 — 1706.5, like section 2 — 1115.1, effects an unconstitutional legislative remittitur. The fact that the legislative remittitur operates in perhaps fewer cases under section 2 — 1706.5 than it would have under section 2 — 1115.1 does not extinguish the constitutional violation.

The Attorney General argues, however, that the damages cap at issue in Best was found by this court to be “arbitrary” and “not rationally related to a legitimate government interest” (Best, 179 Ill. 2d at 408), whereas the present damages cap is rationally related to the Act’s narrow aim of addressing the mounting crisis in access to health care by stemming the cost of malpractice insurance. See Pub. Act 94 — 677, §101(4), eff. August 25, 2005 (identifying the limitation on noneconomic damages as one of the significant reforms to the civil justice system designed to combat the health-care crisis). This argument conflates our special legislation analysis in Best and our separation of powers analysis in that case.

In Best, we first considered the plaintiffs’ special legislation challenge and determined that the rational basis test was appropriate. Best, 179 Ill. 2d at 393. Under this test, “ ‘a court must determine whether the statutory classification is rationally related to a legitimate State interest.’ ” Best, 179 Ill. 2d at 393, quoting In re Petition of the Village of Vernon Hills, 168 Ill. 2d 117, 123 (1995). We ultimately concluded that the damages cap was arbitrary and was not rationally related to a legitimate state interest. Best, 179 Ill. 2d at 406-08. We did not, however, incorporate that holding, rely upon it, or even reference it in our separation of powers discussion, nor was it necessary to do so. Best, 179 Ill. 2d at 410-15.

The separation of powers clause prohibits one branch of government from exercising “powers properly belonging to another.” Ill. Const. 1970, art. II, §1. Thus, the inquiry under the separation of powers clause is not whether the damages cap is rationally related to a legitimate government interest but, rather, whether the legislature, through its adoption of the damages cap, is exercising powers properly belonging to the judiciary. In other words, does the statute unduly encroach on the judiciary’s “sphere of authority” (Allegis Realty Investors v. Novak, 223 Ill. 2d 318, 334 (2006); Best, 179 111. 2d at 410) or “impede the courts in the performance of their functions” (Best, 179 Ill. 2d at 443)? The rational basis test is not part of that legal determination. Numerous cases from this court illustrate the distinction between a separation of powers analysis and a special legislation analysis. See, e.g., In re Estate of Jolliff, 199 Ill. 2d 510 (2002); Burger v. Lutheran General Hospital, 198 Ill. 2d 21 (2001); DeLuna v. St. Elizabeth’s Hospital, 147 Ill. 2d 57 (1992); Bernier v. Burris, 113 Ill. 2d 219 (1986).

For similar reasons, we reject defendants’ argument that section 2 — 1706.5 should not be deemed invalid because, unlike the statute in Best which burdened one class of plaintiffs (Best, 179 Ill. 2d at 407), the Act here balances the benefits and burdens of resolving the healthcare crisis among insurers, health-care providers and patients. This argument, like the one before it, confuses our separation of powers and special legislation analyses. Our observation in Best regarding the burden of any cost savings effected by the damages cap was made in the course of our special legislation discussion. We stated:

“[W]e are unable to discern any connection between the automatic reduction of one type of compensatory damages awarded to one class of injured plaintiffs and a savings in the systemwide costs of litigation. Even assuming that a systemwide savings in costs were achieved by the cap, the prohibition against special legislation does not permit the entire burden of the anticipated cost savings to rest on one class of injured plaintiffs. [Citation.] We therefore reject defendants’ systemic costs rationale as a basis for upholding section 2 — 1115.1.” (Emphasis added.) Best, 179 Ill. 2d at 407.

We did not, in the context of examining the plaintiffs’ separation of powers argument, consider whether the statute burdened a particular group. See Best, 179 Ill. 2d at 410-16. Consideration of that issue was unnecessary because, as explained above, a separation of powers analysis asks whether the statute unduly infringes upon the judiciary’s sphere of authority. Thus, a proper separation of powers analysis of section 2 — 1706.5 does not consider whether the Act balances the benefits and burdens of resolving the health-care crisis or burdens a particular group. The intrusion on the judicial authority effected by section 2 — 1706.5 is no less simply because other provisions of the Act may impose burdens on parties other than plaintiffs.

In a related vein, the Attorney General posits that section 2 — 1706.5 is but one part of a massive “multidimensional” response to the health-care crisis which requires all interested parties — insurers, medical professionals and health-care consumers — to make tradeoffs and sacrifices. According to the Attorney General, the Act, through a number of interrelated measures, constitutes an equitable means of ensuring that everyone who stands to benefit from a resolution of the health-care crisis contributes to its resolution. The Attorney General cites to the Workers’ Compensation Act (820 ILCS 305/1 et seq. (West 2008)) as an example of a multidimensional exercise of the General Assembly’s police power which, although modifying the common law, has been upheld by this court in a long line of cases. See Duley v. Caterpillar Tractor Co., 44 Ill. 2d 15 (1969); Moushon v. National Garages, Inc., 9 Ill. 2d 407 (1956); Grand Trunk Western Ry. Co. v. Industrial Comm’n, 291 Ill. 167 (1919); Matthiessen & Hegeler Zinc Co. v. Industrial Board, 284 Ill. 378 (1918). The Attorney General argues that section 2 — 1706.1, like the Workers’ Compensation Act, constitutes a legitimate exercise of the General Assembly’s police power.

Plaintiffs dispute the Attorney General’s contention that the Act requires all stakeholders to make a sacrifice. Plaintiffs argue that hospitals gain enormous benefits under the Act, but are not required to give anything in return. This aside, plaintiffs further respond that the multidimensional nature of a legislative enactment does not determine whether the enactment is constitutional, and that the statutes at issue in Grasse, Wright, and Best were deemed invalid even though each statute was part of a multidimensional enactment. According to plaintiffs, whether the Act is multidimensional is of no constitutional significance. We agree with plaintiffs.

In Grasse, we held unconstitutional a provision of the Workers’ Compensation Act — the very legislation the Attorney General posits is an example of a multidimensional enactment. Grasse, 412 Ill. at 200. In Wright, we held unconstitutional a statutory damages cap, without regard to the fact that it was but one provision of what may be called a multidimensional act revising the law in relation to medical malpractice. Wright, 63 Ill. 2d at 318, 329-30. Similarly, in Best, we held a damages cap unconstitutional, notwithstanding that it was but one provision of an “integrated ‘reform package.’ ” Best, 179 111. 2d at 465. As these cases demonstrate, though nothing precludes the General Assembly from adopting a so-called “multidimensional” response to a threat to the public welfare, the multidimensional character of a statute does not preclude a finding by this court that the statute is unconstitutional.

Defendants further argue that our decision in Unzicker v. Kraft Food Ingredients Corp., 203 Ill. 2d 64 (2002), which rejected a separation of powers challenge based on Best, teaches that the separation of powers clause does not prevent the General Assembly from dictating when a defendant can be liable for the full amount of a jury’s verdict and that application of Unzicker to the present case demonstrates that section 2 — 1706.5 does not operate as a legislative remittitur. Plaintiffs counter that if Unzicker has any relevance here, it supports the circuit court’s judgment.

In Unzicker we considered the constitutionality of section 2 — 1117 of the Code (735 ILCS 5/2 — 1117 (West 1994)), which modified the common law rule of joint and several liability. Under the common law, a plaintiff could recover compensation for the full amount of his or her injury from any responsible defendant. Unzicker, 203 Ill. 2d at 70. Pursuant to section 2 — 1117, however, any tortfeasor whose percentage of fault the trier of fact determined to be “less than 25% of the total fault attributable to the plaintiff, the defendants sued by the plaintiff, and any third party defendant who could have been sued by the plaintiff, shall be severally liable” for the plaintiffs nonmedical damages. 735 ILCS 5/2 — 1117 (West 1994). Relying on the separation of powers analysis in Best, the plaintiffs argued that the change in the common law rule of joint and several liability amounted to an unconstitutional legislative remittitur. We rejected this argument, noting that, unlike the statute in Best, section 2 — 1117 did not set a cap on damages. Unzicker, 203 Ill. 2d at 94. Rather, section 2 — 1117 merely determined “when a defendant can be held hable for the full amount of a jury’s verdict and when a defendant is hable only in an amount equal to his or her percentage of fault.” Unzicker, 203 Ill. 2d at 94.

Defendants contend that section 2 — 1706.5, hke the statute in Unzicker, does not hmit a plaintiffs recovery and merely provides that certain defendants can be held hable for noneconomic damages only up to a particular amount. We disagree with defendants’ reading of the statute. By its plain terms, section 2 — 1706.5 limits a plaintiff’s noneconomic damages. Section 2 — 1706.5 states, with respect to an award against a hospital and its personnel or hospital affiliates, that “the total amount of non-economic damages shall not exceed $1,000,000.” 735 ILCS 5/2 — 1706.5(a)(1) (West 2008). Section 2 — 1706.5 similarly states, with respect to an award against a physician and the physician’s business or corporate entity and personnel or health-care professional, that “the total amount of non-economic damages shall not exceed $500,000.” 735 ILCS 5/2 — 1706.5(a)(2) (West 2008). Unlike the statute in Unzicker, which required the court to enter judgment in conformity with the jury’s assessment of fault where the defendant was minimally responsible, the statute here requires the court to enter a judgment at variance with the jury’s determination and without regard to the court’s duty to consider, on a case-by-case basis, whether the jury’s verdict is excessive as a matter of law. Defendants’ attempt to fit this statute within the Unzicker analysis is unavailing.

Defendants also argue that the separation of powers clause “allows the legislature to enact statutes affecting the conduct of litigation if its purpose is to serve legitimate legislative goals,” and that the statute here, although affecting the conduct of litigation, is plainly intended to address a health-care crisis. In support, defendants rely chiefly on our analysis in Burger v. Lutheran General Hospital, 198 Ill. 2d 21 (2001), upholding a statutory medical records disclosure provision against a separation of powers challenge.

Defendants’ reliance on Burger is misplaced. As plaintiffs note, Burger did not involve a statute affecting the conduct of litigation. Burger, 198 Ill. 2d at 41. Although the plaintiff in Burger argued that the statute at issue impermissibly infringed upon the judiciary’s inherent authority to regulate discovery, we concluded that the plain language of the statute did not do so, and therefore the statute did “not impinge upon the power of the judiciary.” Burger, 198 Ill. 2d at 39, 45. Moreover, we discern no broad holding in Burger under which a legislative enactment that would otherwise run afoul of separation of powers principles will be deemed to pass constitutional muster simply because the enactment “serves legitimate legislative goals.” The other precedents defendants cite are also inapposite. See Chicago National League Baseball Club, Inc. v. Thompson, 108 Ill. 2d 357, 364-66 (1985) (rejecting a separation of powers challenge to a statute subjecting night baseball games to noise emission standards); Strukoff v. Strukoff, 76 Ill. 2d 53, 57-60 (1979) (rejecting a separation of powers challenge to a statute which required a waiting period between the court’s determination that grounds exist for dissolution of the marriage and the court’s disposition of property).

This is not to say that the legislative purpose or goal of a statute is irrelevant to a separation of powers analysis. In Burger, Thompson, and Strukoff, we considered what the statutes required or regulated and the legislature’s goals in enacting them. Burger, 198 Ill. 2d at 41; Thompson, 108 Ill. 2d at 364; Strukoff, 76 Ill. 2d at 60. Here, too, we necessarily consider what the statute purports to do — limit noneconomic damages in medical malpractice actions — and the legislature’s goal in enacting the statute — responding to a health-care crisis. Our separation of powers analysis, however, does not stop there. The crux of our analysis is whether the statute unduly infringes upon the inherent power of the judiciary. That such an infringement was unintended, based on the language and stated purpose of the statute, does not resolve the constitutional infirmity.

Defendants stress that the General Assembly has the authority to change the common law, which the General Assembly has regularly exercised, and that invalidating section 2 — 1706.5 undermines that authority and calls into question this court’s precedents upholding statutes that limit a plaintiff’s damages. See Bernier v. Burris, 113 Ill. 2d 219 (1986); Siegall v. Solomon, 19 Ill. 2d 145 (1960); Smith v. Hill, 12 Ill. 2d 588 (1958).

The issue is not whether the General Assembly may change the common law. As we recognized in Best, the General Assembly’s authority to “alter the common law and change or limit available remedies *** is well grounded in the jurisprudence of this state.” Best, 179 Ill. 2d at 408, citing Grand Trunk Western Ry. Co., 291 Ill. 167. See also Michigan Avenue National Bank v. County of Cook, 191 Ill. 2d 493, 519 (2000) (“legislature has the inherent authority to repeal or change the common law and may do away with all or part of it”). The General Assembly’s authority, however, is not absolute; it must be exercised within constitutional bounds. See, e.g., People v. Gersch, 135 Ill. 2d 384, 395-98 (1990) (recognizing both the legislature’s inherent power to alter the common law and the court’s duty to invalidate unconstitutional actions of our legislature). Here, the legislature’s attempt in section 2 — 1706.5 to limit common law damages in medical malpractice actions runs afoul of the separation of powers clause.

Invalidating section 2 — 1706.5 does not, as defendants claim, undermine this court’s precedents. In Bernier, Siegall, and Smith, cited by defendants, we rejected constitutional challenges to statutes that prohibited awards of punitive damages in actions for healing art malpractice, alienation of affections, and breach of promise to marry, respectively. In Smith, we expressly rejected a separation of powers challenge to the ban on punitive damages, stating:

“With reference to the act violating article III of the constitution, we have already pointed out that the act does not affect compensatory damages, but only damages considered in their nature as punitive. The act in restricting recovery to actual damages, which term includes both general and special damages and encompasses compensatory damages because they are synonymous, does not invade any judicial functions of the courts. The act in barring punitive damages merely establishes a ‘public policy’ that in the interest of society in the particular class of cases such damages should not be awarded. Such damages being allowed in the interest of society, and not to recompense solely the individual, to deny them cannot be said to deny any constitutional right or to encroach upon any judicial function, or to violate any constitutional guaranty of separation of powers.” Smith, 12 Ill. 2d at 598.

Our analysis in Smith makes plain that a ban on punitive damages is not akin to a cap on noneconomic compensatory damages. Invalidating section 2 — 1706.5 thus does not call into question our holdings in Bernier, Siegall, and Smith.

Defendants further argue that if section 2 — 1706.5 is invalidated, statutes which limit common law liability cannot survive. See 745 ILCS 49/5 et seq. (West 2008) (Good Samaritan Act; eliminating negligence liability for certain health-care professionals and others who voluntarily engage in life-saving activities); 740 ILCS 90/1, 3.1, 3.2, 4 (West 2008) (Innkeeper Protection Act; limiting hotel’s liability for loss or damage to guest property); 745 ILCS 65/4 (West 2008) (Recreational Use of Land and Water Areas Act; eliminating negligence liability of landowners who allow others to use their land free of charge for recreational or conservation purposes); 210 ILCS 50/3.150 (West 2008) (Emergency Medical Services (EMS) Systems Act; eliminating negligence liability for emergency providers of medical services); 730 ILCS 115/ 1(e) (West 2008) (Probation Community Service Act; eliminating negligence liability for organizations and individuals who agree to accept community service from offenders).

We decline to comment on the constitutionality of statutes that are not before us. We note, however, that, unlike section 2 — 1706.5, none of the statutes defendants cite requires a court to reduce a jury’s award of noneconomic damages to a predetermined limit, irrespective of the facts of the case. Though the Innkeeper Protection Act does set a dollar cap for a hotel’s liability for damage or loss to guest property, the statute also allows the parties to contract around the statutory limit. 740 ILCS 90/1, 3, 3.1, 3.2, 4 (West 2008). Thus, the Innkeeper Protection Act does not parallel section 2 — 1706.5.

Defendants direct this court’s attention to statutes limiting noneconomic damages in medical malpractice cases that have been adopted in other states. See Alaska Stat. §09.55.549 (2007) ($250,000 to $400,000 cap); Cal. Civ. Code §3333.2 (West 2009) ($250,000 cap); Colo. Rev. Stat. §13 — 64—302 (2008) ($300,000 cap); Fla. Stat. §766.118 (2009) ($150,000 to $1,500,000 cap); Ga. Code Ann. §51 — 13—1(b) (2009) ($350,000 to $1,050,000 cap); Haw. Rev. Stat. §663 — 8.7 (2009) ($375,000 cap); Idaho Code Ann. §6 — 1603 (2008) ($250,000 cap); Md. Code Ann. Cts. & Jud. Proc. §3 — 2A—09 (2009) ($650,000 cap with $15,000 annual increase beginning January 1, 2009); Miss. Code Ann. §11 — 1—60(2)(a) (2008) ($500,000 cap); Mo. Rev. Stat. §538.210 (2009) ($350,000 cap); Nev. Rev. Stat. §41A.035 (2009) ($350,000 cap); N.D. Cent. Code §32 — 42—02 (2009) ($500,000 cap); Ohio Rev. Code Ann. §§2323.43(A)(2), (A)(3) (West 2009) ($250,000 to $1,000,000 cap); Okla. Stat. tit. 63, §§1 — 1708.IF, 1 — 1708. IF — 1 (2009) ($300,000 cap which may be lifted in some cases); S.C. Code Ann. §15 — 32—220 (2008) ($350,000 to $1,050,000 cap with annual adjustment); Tex. Civ. Prac. & Rem. Code Ann. §74.301 (Vernon 2009) ($250,000 to $500,000 cap); Utah Code Ann. §78B — 3— 410 (2008) ($400,000 cap beginning July 1, 2002, plus yearly inflation adjustment); W. Va. Code §55 — 7B—8 (2008) ($250,000 to $500,000 cap, plus yearly inflation adjustment); Wis. Stat. §893.55(4)(d)(l) (2008) ($750,000 cap). Defendants contend that the limits on damages contained in section 2 — 1706.5 are well within the range of reasonable limits adopted by these states, and that the General Assembly is on solid constitutional footing when the lines it draws are “within the general area of limits that had been set by other States.” Anderson v. Wagner, 79 Ill. 2d 295, 312 (1979).

We have reviewed the statutes defendants cite and observe that the limitations on noneconomic damages adopted in other states vary widely, not only in the amount of the cap, but other specifics. For example, the California statute provides simply: “In no [medical malpractice] action shall the amount of damages for noneconomic losses exceed two hundred fifty thousand dollars ($250,000).” Cal. Civ. Code §3333.2(b) (West 2009). In contrast, the Florida statute sets up a more complex scheme, in which the damages cap may be as low as $150,000 and as high as $1.5 million, depending upon whether the medical negligence is attributable to a practitioner or nonpractitioner; the negligence results in a permanent vegetative state or death; the negligence caused a catastrophic injury to the patient; or the negligence occurred during the provision of emergency care. Fla. Stat. §766.118 (2009). On what basis defendants have determined that such disparate provisions are all reasonable is not known, and it is not for this court to judge the reasonableness of other states’ legislation. Moreover, defendants’ contention that because the damages caps established by section 2 — 1706.5 fit within the range of caps established by other states is not dispositive of whether section 2 — 1706.5 runs afoul of the separation of powers clause of this state’s constitution. That “everybody is doing it” is hardly a litmus test for the constitutionality of the statute.

We are also not persuaded by defendants’ argument that the circuit court’s judgment should be reversed because courts of other states, which have considered whether a limitation on noneconomic damages violates separation of powers, have rejected this argument. Defendants cite Garhart v. Columbia/HealthOne, L.L.C., 95 P.3d 571, 581-82 (Colo. 2004), Zdrojewski v. Murphy, 254 Mich. App. 50, 81-82, 657 N.W.2d 721, 739 (2002); Judd v. Drezga, 2004 UT 91, ¶36,103 P.3d 135, and Estate of Verba v. Ghaphery, 210 W. Va. 30, 35, 552 S.E.2d 406, 411 (2001). Our own research reveals additional cases from other states rejecting separation of powers challenges to their statutes capping noneconomic damages in medical malpractice actions. See, e.g., Evans v. State, 56 P.3d 1046, 1055-56 (Alaska 2002); Kirkland v. Blaine County Medical Center, 134 Idaho 464, 470-71, 4 P.3d 1115, 1121-22 (2000); Owens-Corning v. Walatka, 125 Md. App. 313, 335-39, 725 A.2d 579, 590-02 (1999); Gourley v. Nebraska Methodist Health System, Inc., 265 Neb. 918, 955-56, 663 N.W.2d 43, 76 (2003).

Although decisions from other jurisdictions can provide guidance where precedent from Illinois is lacking, we do not write today on a blank slate. Our decision in Best guides our analysis. That the courts of other states would hold differently based on their constitutional jurisprudence applied to their statutes is of no moment. “This court’s jurisprudence of state constitutional law cannot be predicated on *** the actions of our sister states ***.” People v. Caballes, 221 Ill. 2d 282, 313 (2006).

We hold that the limitation on noneconomic damages in medical malpractice actions set forth in section 2 — 1706.5 of the Code violates the separation of powers clause of the Illinois Constitution (Ill. Const. 1970, art. II, §1) and is invalid. Because the Act contains an inseverability provision (Pub. Act 94 — 677, §995, eff. August 25, 2005), we hold the Act invalid and void in its entirety. We emphasize, however, that because the other provisions contained in Public Act 94 — 677 are deemed invalid solely on inseverability grounds, the legislature remains free to reenact any provisions it deems appropriate.

II

The partial concurrence and partial dissent is in agreement with the majority opinion on one relatively minor point (that this case presents a facial, and not an “as applied,” constitutional challenge) and is otherwise opposed to the majority’s legal analysis and holding. Therefore, for ease of discussion, we will refer to the partial concurrence and partial dissent simply as the “dissent.”

Among the dissent’s criticisms is that we have “rush[ed]” to address the constitutionality of Public Act 94 — 677; that we only “purport” to defend the constitution; and that we stand as an “obstacle” to the legislature’s efforts to find an answer to the health-care crisis, “put[ting] at risk the welfare of the people.” 237 Ill. 2d at 260-61, 270, 284 (Karmeier, J., concurring in part and dissenting in part, joined by Garman, J.). The dissent implies that the majority opinion is somehow an affront to the health-care reform efforts of the Obama Administration, and expressly cautions that if we “persist! ] in invalidating damages caps,” dire consequences will likely follow. 237 Ill. 2d at 255, 283 (Karmeier, J., concurring in part and dissenting in part, joined by Garman, J.).

Plainly, the Obama Administration’s health-care reform efforts are not the backdrop against which we have decided the constitutionality of Public Act 94 — 677, and we express no opinion — favorable or otherwise — -as to those efforts. Rather, our decision in this case, that Public Act 94 — 677 cannot stand, is based, as it must be, on the binding provisions of our state constitution and our case law interpreting the same. Although we do not expect that the members of this court will always agree as to what the law is, or how to apply the law in a given case, we do expect that our disagreements will focus on the legal issues, providing a level of discourse appropriate to the state’s highest court. The emotional and political rhetoric that peppers the dissent is ill-suited to this pursuit.

As to the legal issues the dissent does raise, we accept that, with respect to the applicability of the Best decision, the members of this court cannot speak with a unanimous voice. The dissent is as firm in its belief that Best was wrongly decided as the majority is in its conclusion that Best is as valid today as it was in 1997 and controls the disposition of the present case. Our reasons therefor have already been set forth above, and we find it unnecessary to reiterate those reasons in contradistinction to the dissent’s views.

We are constrained, however, to respond directly to one issue raised by the dissent, namely, that this court lacks subject matter jurisdiction to consider the constitutionality of Public Act 94 — 677. 237 Ill. 2d at 264 (Karmeier, J., concurring in part and dissenting in part, joined by Garman, J.). Because a reviewing court has a “duty to consider its jurisdiction and dismiss the appeal if it determines that jurisdiction is wanting,” we will consider this issue. Archer Daniels Midland Co. v. Barth, 103 Ill. 2d 536, 539 (1984). See also In re M.W., 232 Ill. 2d 408, 417 (2009) (“lack of subject matter jurisdiction is not subject to waiver”).

The dissent’s view that this court lacks jurisdiction is based on its conclusion that plaintiffs lack standing to challenge the constitutionality of Public Act 94 — 677 and that the constitutional issue is not ripe for review. 237 Ill. 2d at 268 (Karmeier, J., concurring in part and dissenting in part, joined by Garman J.). As discussed below, issues of standing and ripeness do not implicate our subject matter jurisdiction.

The related doctrines of standing and ripeness “seek[ ] to insure that courts decide actual controversies and not abstract questions.” People v. $1,124,905 U.S. Currency & One 1988 Chevrolet Astro Van, 177 Ill. 2d 314, 328 (1997). See also Wexler v. Wirtz Corp., 211 Ill. 2d 18, 23 (2004) (“doctrine of standing is to insure that issues are raised only by those parties with a real interest in the outcome of the controversy”); People v. Glisson, 188 Ill. 2d 211, 221 (1999) (same); Best, 179 Ill. 2d at 382-84 (discussing ripeness with respect to declaratory judgment statute); Weber v. St. Paul Fire & Marine Insurance Co., 251 Ill. App. 3d 371, 372-73 (1993) (“whether an action is ‘premature,’ that is, not ripe for adjudication, focuses on an evaluation of the fitness of the issue for judicial decision at that point in time”).

Under Illinois law, lack of standing is an affirmative defense, which is the defendant’s burden to plead and prove. Wexler, 211 Ill. 2d at 22-23; In re Estate of Schlenker, 209 Ill. 2d 456, 461, 464 (2004); Greer v. Illinois Housing Development Authority, 122 Ill. 2d 462, 494 (1988). While a lack of subject matter jurisdiction cannot be forfeited (M.W., 232 Ill. 2d at 417), a lack of standing will be forfeited if not raised in a timely manner in the trial court (Skolnick v. Altheimer & Gray, 191 Ill. 2d 214, 237 (2000); Greer, 122 Ill. 2d at 508; Lyons v. Ryan, 324 Ill. App. 3d 1094, 1101 n.5 (2001)). Ripeness, like standing, is also subject to forfeiture if not raised in the trial court. In re General Order of October 11, 1990, 256 Ill. App. 3d 693, 696 (1993).

In the present case, Gottlieb and Martinoz did not assert in the trial court that plaintiffs lack standing, nor did they argue that the constitutional issue was not ripe for review. Thus, we deem these arguments forfeited by these defendants. Dr. Levi-D ’Ancona, however, did assert lack of standing and ripeness as his first and second affirmative defenses, and moved for judgment on the pleadings as to these two defenses. The circuit court rejected Dr. Levi-D’Ancona’s arguments and denied his motion for judgment on the pleadings. Relying on Best, the circuit court concluded that plaintiffs at least had standing to challenge the statutory cap on noneconomic damages and that the constitutionality of the statutory cap was ripe for review. The circuit court observed that catastrophic injuries similar to those pled by plaintiffs in the instant case were pled in the complaints at issue in Best, and that this court held that “plaintiffs have alleged a sufficient and direct interest in the application of the challenged provisions *** to their lawsuits.” Best, 179 Ill. 2d at 383. Significantly, Dr. Levi-D ’Ancona did not renew his standing and ripeness arguments before this court. Under our Rule 341, “[ploints not argued [in the appellant’s brief] are waived.” 210 Ill. 2d R. 341(h)(7). Accord Skolnick, 191 Ill. 2d at 237 (this court “will not supply contentions not advanced by the parties”).

Because issues of standing and ripeness do not implicate this court’s subject matter jurisdiction, and because the only party who raised these issues below has abandoned them on review, we decline to address these issues on the merits.⁴

CONCLUSION

For the reasons stated, we reverse the judgment of the circuit court finding the statute unconstitutional as applied to plaintiffs, affirm the judgment of the circuit court finding the statute facially invalid, and remand this matter to the circuit court for further proceedings.

Affirmed in part and reversed in part;

cause remanded.

JUSTICE THOMAS took no part in the consideration or decision of this case.

1 Plaintiffs also challenged the Act’s amendment of section 2- — 622 of the Code that changed the certificate of merit requirements for medical malpractice actions; the Act’s adoption of section 2 — 1704.5 that, inter alia, permits future medical expenses and costs of life care to be paid through purchase of an annuity; the Act’s amendment of section 8 — 1901 that established an evidentiary rule concerning a health-care provider’s admission of liability; and the Act’s amendment of section 8 — 2501 that changed the expert witness standards in medical malpractice actions. See Pub. Act 94 — 677, §330, eff. August 25, 2005, amending 735 ILCS 5/2 — 622, 8 — 1901, 8 — 2501, and adding 735 ILCS 5/2 — 1704.5.

2 Anticipating other challenges to Public Act 94 — 677, the presiding judge of the Law Division of the Cook County circuit court ordered that all pending and subsequently filed motions in any case challenging the constitutionality of the Act be consolidated before the same judge presiding over plaintiffs’ case. Thus, Lebron v. Gottlieb became the lead case. The record identifies two other cases pending in Cook County in which a party challenged the constitutionality of the Act: Alexander v. Nacopoulos, No. 07—L—2207, and Zago v. Resurrection Medical Center, No. 07—L-1720.

3 Amicus curiae briefs in support of plaintiffs were received from the American Bar Association; Chicago Bar Association and Illinois State Bar Association; Citizen Action/Illinois and Illinois Alliance for Retired Americans; Illinois AFL-CIO and the Chicago Federation of Labor; Illinois Trial Lawyers Association; National Association for the Advancement of Colored People and Cook County Bar Association; Professors Neil Vidmar, Tom Baker, Ralph L. Brill, Martha Chamallas, Stephen Daniels, Thomas A. Eaton, Theodore Eisenberg, Neal Feigenson, Lucinda M. Finley, Marc Galanter, Valerie E Hans, Michael Heise, Edward J. Kionka, Thomas H. Koenig, Herbert M. Kritzer, David I. Levine, Nancy S. Marder, Joanne Martin, Frank M. McClellan, Deborah Jones Merritt, Philip G. Peters, Jr., James T. Richardson, Charles Silver, and Richard W. Wright; and the Women’s Bar Association of Illinois. Amicus curiae briefs in support of defendants were received from Advocate Health and Hospitals Corporation; American Medical Association and Illinois State Medical Society; the Cook County State’s Attorney; Illinois Hospital Association, American Hospital Association, Illinois Catholic Health Association, and Illinois Rural Health Association; and Loyola University Medical Center and Loyola University Physician Foundation.

4 The dissent’s conclusion that standing and ripeness raise jurisdictional concerns which this court must address even if the parties have not done so might be worthy of consideration if this case was proceeding in federal court. Under federal law, standing is a threshold question under the case-or-controversy requirement of article III of the United States Constitution (U.S. Const., art. Ill, §2; Worth v. Seldin, 422 U.S. 490, 498, 45 L. Ed. 2d 343, 354, 95 S. Ct. 2197, 2205 (1975)), which plaintiffs bear the burden of pleading and proving (Lujan v. Defenders of Wildlife, 504 U.S. 555, 560-61, 119 L. Ed. 2d 351, 364, 112 S. Ct. 2130, 2136 (1992)). Accord Elk Grove Unified School District v. Newdow, 542 U.S. 1, 11-12, 159 L. Ed. 2d 98, 108-09, 124 S. Ct. 2301, 2308-09 (2004). Article III standing is jurisdictional and not subject to waiver. United States v. Hays, 515 U.S. 737, 742, 132 L. Ed. 2d 635, 642, 115 S. Ct. 2431, 2435 (1995). See also Native American Arts, Inc. v. Waldron Corp., 253 F. Supp. 2d 1041,1045 (N.D. Ill. 2003) (concluding that, by definition, article III standing is not an affirmative defense). This court is not required to follow federal law on issues of standing, and has expressly rejected federal principles of standing. See Greer, 122 Ill. 2d at 494 (holding that, in Illinois, lack of standing is an affirmative defense, and contrasting Illinois with federal courts “where lack of article III (U.S. Const., art. Ill) standing is a bar to jurisdiction”).