Bill Text: TX SB4 | 2021 | 87th Legislature 2nd Special Session | Enrolled
Bill Title: Relating to abortion complication reporting and the regulation of drug-induced abortion procedures, providers, and facilities; creating a criminal offense.
Sponsorship: Broadly Bipartisan Bill
Status: (Passed) 2021-09-17 - Effective on . . . . . . . . . . . . . . . December 2, 2021 [SB4 Detail]
Download: Texas-2021-SB4-Enrolled.html
| S.B. No. 4 | ||
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| relating to abortion complication reporting and the regulation of | ||
| drug-induced abortion procedures, providers, and facilities; | ||
| creating a criminal offense. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. The legislature finds that: | ||
| (1) this state has an interest in protecting the | ||
| health and welfare of every woman considering a drug-induced | ||
| abortion; | ||
| (2) the use of Mifeprex or mifepristone presents | ||
| significant medical complications including, but not limited to, | ||
| uterine hemorrhage, viral infections, abdominal pain, cramping, | ||
| vomiting, headache, fatigue, and pelvic inflammatory disease; and | ||
| (3) the failure rate and risk of complications | ||
| increases with advancing gestational age. | ||
| SECTION 2. Sections 171.006(a) and (b), Health and Safety | ||
| Code, as added by Chapter 4 (H.B. 13), Acts of the 85th Legislature, | ||
| 1st Called Session, 2017, are amended to read as follows: | ||
| (a) In this section, "abortion complication" or "adverse | ||
| event" means any harmful event or adverse outcome with respect to a | ||
| patient related to an abortion that is performed or induced on the | ||
| patient and that is diagnosed or treated by a health care | ||
| practitioner or at a health care facility and includes: | ||
| (1) shock; | ||
| (2) uterine perforation; | ||
| (3) cervical laceration; | ||
| (4) hemorrhage; | ||
| (5) aspiration or allergic response; | ||
| (6) infection; | ||
| (7) sepsis; | ||
| (8) death of the patient; | ||
| (9) incomplete abortion; | ||
| (10) damage to the uterus; [ |
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| (11) an infant born alive after the abortion; | ||
| (12) blood clots resulting in pulmonary embolism or | ||
| deep vein thrombosis; | ||
| (13) failure to actually terminate the pregnancy; | ||
| (14) pelvic inflammatory disease; | ||
| (15) endometritis; | ||
| (16) missed ectopic pregnancy; | ||
| (17) cardiac arrest; | ||
| (18) respiratory arrest; | ||
| (19) renal failure; | ||
| (20) metabolic disorder; | ||
| (21) embolism; | ||
| (22) coma; | ||
| (23) placenta previa in subsequent pregnancies; | ||
| (24) preterm delivery in subsequent pregnancies; | ||
| (25) fluid accumulation in the abdomen; | ||
| (26) hemolytic reaction resulting from the | ||
| administration of ABO-incompatible blood or blood products; | ||
| (27) adverse reactions to anesthesia or other drugs; | ||
| or | ||
| (28) any other adverse event as defined by the United | ||
| States Food and Drug Administration's criteria provided by the | ||
| MedWatch Reporting System. | ||
| (b) The reporting requirements of this section apply only | ||
| to: | ||
| (1) a physician who: | ||
| (A) performs or induces at an abortion facility | ||
| an abortion that results in an abortion complication diagnosed or | ||
| treated by that physician; or | ||
| (B) diagnoses or treats [ |
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| an abortion complication that is the result of an abortion | ||
| performed or induced by another physician [ |
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| (2) a health care facility that is a hospital, | ||
| abortion facility, freestanding emergency medical care facility, | ||
| or health care facility that provides emergency medical care, as | ||
| defined by Section 773.003. | ||
| SECTION 3. Section 171.061, Health and Safety Code, is | ||
| amended by amending Subdivisions (2) and (5) and adding | ||
| Subdivisions (2-a) and (8-a) to read as follows: | ||
| (2) "Abortion-inducing drug" means a drug, a medicine, | ||
| or any other substance, including a regimen of two or more drugs, | ||
| medicines, or substances, prescribed, dispensed, or administered | ||
| with the intent of terminating a clinically diagnosable pregnancy | ||
| of a woman and with knowledge that the termination will, with | ||
| reasonable likelihood, cause the death of the woman's unborn child. | ||
| The term includes off-label use of drugs, medicines, or other | ||
| substances known to have abortion-inducing properties that are | ||
| prescribed, dispensed, or administered with the intent of causing | ||
| an abortion, including the Mifeprex regimen, misoprostol | ||
| (Cytotec), and methotrexate. The term does not include a drug, | ||
| medicine, or other substance that may be known to cause an abortion | ||
| but is prescribed, dispensed, or administered for other medical | ||
| reasons. | ||
| (2-a) "Adverse event" or "abortion complication" | ||
| means any harmful event or adverse outcome with respect to a patient | ||
| related to an abortion, including the abortion complications listed | ||
| in Section 171.006, as added by Chapter 4 (H.B. 13), Acts of the | ||
| 85th Legislature, 1st Called Session, 2017. | ||
| (5) "Medical abortion" means the administration or use | ||
| of an abortion-inducing drug to induce an abortion, and may also be | ||
| referred to as a "medication abortion," a "chemical abortion," a | ||
| "drug-induced abortion," "RU-486," or the "Mifeprex regimen". | ||
| (8-a) "Provide" means, as used with regard to | ||
| abortion-inducing drugs, any act of giving, selling, dispensing, | ||
| administering, transferring possession, or otherwise providing or | ||
| prescribing an abortion-inducing drug. | ||
| SECTION 4. The heading to Section 171.063, Health and | ||
| Safety Code, is amended to read as follows: | ||
| Sec. 171.063. PROVISION [ |
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| ABORTION-INDUCING DRUG. | ||
| SECTION 5. Section 171.063, Health and Safety Code, is | ||
| amended by amending Subsections (a), (c), and (e) and adding | ||
| Subsection (b-1) to read as follows: | ||
| (a) A person may not knowingly [ |
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| pregnant woman for the purpose of inducing an abortion in the | ||
| pregnant woman or enabling another person to induce an abortion in | ||
| the pregnant woman unless: | ||
| (1) the person who [ |
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| is a physician; and | ||
| (2) [ |
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| the provision[ |
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| abortion-inducing drug satisfies the protocol [ |
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| authorized by this subchapter [ |
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| (b-1) A manufacturer, supplier, physician, or any other | ||
| person may not provide to a patient any abortion-inducing drug by | ||
| courier, delivery, or mail service. | ||
| (c) Before the physician [ |
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| the physician must: | ||
| (1) examine the pregnant woman in person; | ||
| (2) independently verify that a pregnancy exists; | ||
| (3) [ |
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| gestational age and intrauterine location of the pregnancy to | ||
| determine whether an ectopic pregnancy exists; | ||
| (4) determine the pregnant woman's blood type, and for | ||
| a woman who is Rh negative, offer to administer Rh immunoglobulin | ||
| (RhoGAM) at the time the abortion-inducing drug is administered or | ||
| used or the abortion is performed or induced to prevent Rh | ||
| incompatibility, complications, or miscarriage in future | ||
| pregnancies; | ||
| (5) document whether the pregnant woman received | ||
| treatment for Rh negativity, as diagnosed by the most accurate | ||
| standard of medical care; and | ||
| (6) ensure the physician does not provide an | ||
| abortion-inducing drug for a pregnant woman whose pregnancy is more | ||
| than 49 days of gestational age. | ||
| (e) A [ |
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| drug, or the physician's agent, must schedule a follow-up visit for | ||
| the woman to occur not later [ |
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| after the earliest date on which the abortion-inducing drug is | ||
| administered [ |
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| or induced [ |
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| must: | ||
| (1) confirm that the woman's pregnancy is completely | ||
| terminated; and | ||
| (2) assess any continued blood loss [ |
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| SECTION 6. Subchapter D, Chapter 171, Health and Safety | ||
| Code, is amended by adding Sections 171.0631, 171.0632, 171.065, | ||
| and 171.066 to read as follows: | ||
| Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIRED. A | ||
| person may not provide an abortion-inducing drug to a pregnant | ||
| woman without satisfying the applicable informed consent | ||
| requirements of Subchapter B. | ||
| Sec. 171.0632. REPORTING REQUIREMENTS. A physician who | ||
| provides an abortion-inducing drug must comply with the applicable | ||
| physician reporting requirements under Section 245.011. | ||
| Sec. 171.065. CRIMINAL OFFENSE. (a) A person who | ||
| intentionally, knowingly, or recklessly violates this subchapter | ||
| commits an offense. An offense under this subsection is a state | ||
| jail felony. | ||
| (b) A pregnant woman on whom a drug-induced abortion is | ||
| attempted, induced, or performed in violation of this subchapter is | ||
| not criminally liable for the violation. | ||
| (c) Conduct constituting an offense under this section may | ||
| also be the basis for an administrative violation under Section | ||
| 171.064. | ||
| Sec. 171.066. ENFORCEMENT OF SUBCHAPTER. A state executive | ||
| or administrative official may not decline to enforce this | ||
| subchapter, or adopt a construction of this subchapter in a way that | ||
| narrows its applicability, based on the official's own beliefs on | ||
| the requirements of the state or federal constitution, unless the | ||
| official is enjoined by a state or federal court from enforcing this | ||
| subchapter. | ||
| SECTION 7. The following provisions of the Health and | ||
| Safety Code are repealed: | ||
| (1) Sections 171.061(3) and (6); and | ||
| (2) Section 171.063(b). | ||
| SECTION 8. (a) Nothing in this Act shall be construed as | ||
| creating or recognizing a right to abortion. | ||
| (b) It is not the intention of this Act to make lawful an | ||
| abortion that is otherwise unlawful. | ||
| (c) Except as specifically provided by Section 7 of this | ||
| Act, nothing in this Act repeals, replaces, or otherwise | ||
| invalidates existing Texas laws, regulations, or policies. | ||
| SECTION 9. Any provision of this Act held to be invalid or | ||
| unenforceable by its terms or as applied to any person or | ||
| circumstance shall be construed to give the provision the maximum | ||
| effect permitted by law, unless such holding is one of utter | ||
| invalidity or unenforceability, in which event the provision shall | ||
| be considered severable from the other provisions of this Act and | ||
| shall not affect the remainder or the application of the provisions | ||
| to other persons not similarly situated or to other, dissimilar | ||
| circumstances. | ||
| SECTION 10. (a) Except as provided by Subsection (b) of | ||
| this section, the changes in law made by this Act apply only to an | ||
| abortion performed or induced on or after the effective date of this | ||
| Act. | ||
| (b) Section 171.065, Health and Safety Code, as added by | ||
| this Act, applies only to an abortion performed or induced on or | ||
| after January 1, 2022. | ||
| SECTION 11. This Act takes effect immediately if it | ||
| receives a vote of two-thirds of all the members elected to each | ||
| house, as provided by Section 39, Article III, Texas Constitution. | ||
| If this Act does not receive the vote necessary for immediate | ||
| effect, this Act takes effect on the 91st day after the last day of | ||
| the legislative session. | ||
| ______________________________ | ______________________________ | |
| President of the Senate | Speaker of the House | |
| I hereby certify that S.B. No. 4 passed the Senate on | ||
| August 11, 2021, by the following vote: Yeas 19, Nays 10. | ||
| ______________________________ | ||
| Secretary of the Senate | ||
| I hereby certify that S.B. No. 4 passed the House on | ||
| August 31, 2021, by the following vote: Yeas 82, Nays 41, one | ||
| present not voting. | ||
| ______________________________ | ||
| Chief Clerk of the House | ||
| Approved: | ||
| ______________________________ | ||
| Date | ||
| ______________________________ | ||
| Governor | ||
