Bill Text: TX SB20 | 2017-2018 | 85th Legislature | Comm Sub


Bill Title: Relating to health plan and health benefit plan coverage for abortions.

Spectrum: Strong Partisan Bill (Republican 15-1)

Status: (Introduced) 2017-03-22 - Record vote [SB20 Detail]

Download: Texas-2017-SB20-Comm_Sub.html
 
 
  By: Taylor of Galveston, et al.  S.B. No. 20
         (In the Senate - Filed January 6, 2017; January 24, 2017,
  read first time and referred to Committee on Business & Commerce;
  March 16, 2017, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 7, Nays 1; March 16, 2017,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 20 By:  Taylor of Galveston
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to health plan and health benefit plan coverage for
  abortions.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Title 8, Insurance Code, is amended by adding
  Subtitle M to read as follows:
  SUBTITLE M.  FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT
  CHAPTER 1695.  LEGISLATIVE CONSIDERATIONS
         Sec. 1695.001.  CONSTITUTIONALITY OF PATIENT PROTECTION AND
  AFFORDABLE CARE ACT. This subtitle does not constitute an
  acknowledgment by the legislature of the legitimacy of the Patient
  Protection and Affordable Care Act (Pub. L. No. 111-148) as a
  constitutional exercise of the power of the United States Congress.
  CHAPTER 1696.  COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
         Sec. 1696.001.  DEFINITIONS.  In this chapter:
               (1)  "Abortion" and "medical emergency" have the
  meanings assigned by Section 171.002, Health and Safety Code.
               (2)  "Health benefit exchange" means an American Health
  Benefit Exchange administered by the federal government or created
  under Section 1311(b) of the Patient Protection and Affordable Care
  Act (42 U.S.C. Section 18031(b)).
               (3)  "Qualified health plan" has the meaning assigned
  by Section 1301(a) of the Patient Protection and Affordable Care
  Act (42 U.S.C. Section 18021(a)).
         Sec. 1696.002.  PROHIBITED COVERAGE THROUGH HEALTH BENEFIT
  EXCHANGE.  (a)  A qualified health plan offered through a health
  benefit exchange may not provide coverage for an abortion other
  than coverage for an abortion performed due to a medical emergency.
         (b)  This section does not prevent a person from purchasing
  optional or supplemental coverage for abortions under a health
  benefit plan other than a qualified health plan offered through a
  health benefit exchange.
         SECTION 2.  Subtitle A, Title 8, Insurance Code, is amended
  by adding Chapter 1218 to read as follows:
  CHAPTER 1218.  COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
         Sec. 1218.001.  DEFINITIONS. In this chapter, "abortion"
  and "medical emergency" have the meanings assigned by Section
  171.002, Health and Safety Code.
         Sec. 1218.002.  APPLICABILITY OF CHAPTER. (a)  This chapter
  applies only to a health benefit plan that provides benefits for
  medical or surgical expenses incurred as a result of a health
  condition, accident, or sickness, including an individual, group,
  blanket, or franchise insurance policy or insurance agreement, a
  group hospital service contract, or an individual or group evidence
  of coverage or similar coverage document that is offered by:
               (1)  an insurance company;
               (2)  a group hospital service corporation operating
  under Chapter 842;
               (3)  a fraternal benefit society operating under
  Chapter 885;
               (4)  a stipulated premium company operating under
  Chapter 884;
               (5)  an exchange operating under Chapter 942;
               (6)  a health maintenance organization operating under
  Chapter 843;
               (7)  a multiple employer welfare arrangement that holds
  a certificate of authority under Chapter 846; or
               (8)  an approved nonprofit health corporation that
  holds a certificate of authority under Chapter 844.
         (b)  This chapter applies to group health coverage made
  available by a school district in accordance with Section 22.004,
  Education Code.
         (c)  Notwithstanding any provision in Chapter 1551, 1575,
  1579, or 1601 or any other law, this chapter applies to:
               (1)  a basic coverage plan under Chapter 1551;
               (2)  a basic plan under Chapter 1575;
               (3)  a primary care coverage plan under Chapter 1579;
  and
               (4)  basic coverage under Chapter 1601.
         (d)  Notwithstanding Section 1501.251 or any other law, this
  chapter applies to coverage under a small or large employer health
  benefit plan subject to Chapter 1501.
         (e)  Notwithstanding Section 1507.003 or 1507.053, this
  chapter applies to a standard health benefit plan provided under
  Chapter 1507.
         Sec. 1218.003.  COVERAGE BY HEALTH BENEFIT PLAN. A health
  benefit plan may provide coverage for abortion only if:
               (1)  the coverage is provided to an enrollee separately
  from other health benefit plan coverage offered by the health
  benefit plan issuer;
               (2)  an enrollee pays separately from, and in addition
  to, the premium for other health benefit plan coverage a premium for
  coverage for abortion;
               (3)  an enrollee provides a signature for coverage for
  abortion, separately and distinct from the signature required for
  other health benefit plan coverage offered by the health benefit
  plan issuer; or
               (4)  the coverage provides benefits only for an
  abortion performed due to a medical emergency.
         Sec. 1218.004.  CALCULATION OF PREMIUM. (a)  A health
  benefit plan issuer that provides coverage for abortion shall
  calculate the premium for the coverage so that the premium fully
  covers the estimated cost of abortion per enrollee, determined on
  an actuarial basis.
         (b)  In calculating a premium under Subsection (a), the
  health benefit plan issuer may not take into account any cost
  savings in other health benefit plan coverage offered by the health
  benefit plan issuer that is estimated to result from coverage for
  abortion.
         (c)  A health benefit plan issuer that provides coverage
  other than coverage for abortion may not provide a premium discount
  to or reduce the premium for an enrollee for coverage other than
  coverage for abortion on the basis that the enrollee has health
  benefit plan coverage for abortion.
         Sec. 1218.005.  NOTICE BY ISSUER. A health benefit plan
  issuer that provides coverage for abortion shall at the time of
  enrollment in the health benefit plan provide each enrollee with a
  notice that:
               (1)  coverage for abortion is optional and separate
  from other health benefit plan coverage offered by the health
  benefit plan issuer;
               (2)  the premium cost for coverage for abortion is a
  premium paid separately from, and in addition to, the premium for
  other health benefit plan coverage offered by the health benefit
  plan issuer; and
               (3)  the enrollee may enroll in a health benefit plan
  that provides coverage other than coverage for abortion without
  obtaining coverage for abortion.
         SECTION 3.  This Act applies only to a qualified health plan
  offered through a health benefit exchange or a health benefit plan
  that is delivered, issued for delivery, or renewed on or after
  January 1, 2018. A qualified health plan offered through a health
  benefit exchange or a health benefit plan that is delivered, issued
  for delivery, or renewed before January 1, 2018, is governed by the
  law as it existed immediately before the effective date of this Act,
  and that law is continued in effect for that purpose.
         SECTION 4.  This Act takes effect September 1, 2017.
 
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