Bill Text: TX SB8 | 2017 | 85th Legislature 1st Special Session | Engrossed


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

Spectrum: Partisan Bill (Republican 20-0)

Status: (Engrossed) 2017-07-27 - Received from the Senate [SB8 Detail]

Download: Texas-2017-SB8-Engrossed.html
 
 
  By: Creighton, et al. S.B. No. 8
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to health plan and health benefit plan coverage for
  elective abortion.
         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 ELECTIVE ABORTION; PROHIBITIONS AND
  REQUIREMENTS
         Sec. 1696.001.  DEFINITIONS.  In this chapter:
               (1)  "Elective abortion" means an abortion, as defined
  by Section 245.002, Health and Safety Code, other than an abortion
  performed due to a medical emergency as defined 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 elective abortion.
         (b)  This section does not prevent a person from purchasing
  optional or supplemental coverage for elective abortion 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 ELECTIVE ABORTION; PROHIBITIONS AND
  REQUIREMENTS
         Sec. 1218.001.  DEFINITION. In this chapter, "elective
  abortion" means an abortion, as defined by Section 245.002, Health
  and Safety Code, other than an abortion performed due to a medical
  emergency as defined 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 or any
  other law, this chapter applies to a standard health benefit plan
  provided under Chapter 1507.
         Sec. 1218.003.  CERTAIN COVERAGE NOT AFFECTED. This chapter
  does not apply to health benefit plan coverage provided to an
  enrollee for any abortion other than an elective abortion as
  defined by Section 1218.001.
         Sec. 1218.004.  COVERAGE BY HEALTH BENEFIT PLAN. A health
  benefit plan may provide coverage for elective 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)  the enrollee pays the premium for coverage for
  elective abortion separately from, and in addition to, the premium
  for other health benefit plan coverage, if any; and
               (3)  the enrollee provides a signature for coverage for
  elective abortion, separately and distinct from the signature
  required for other health benefit plan coverage, if any, provided
  to the enrollee by the health benefit plan issuer.
         Sec. 1218.005.  CALCULATION OF PREMIUM. (a)  A health
  benefit plan issuer that provides coverage for elective abortion
  shall calculate the premium for the coverage so that the premium
  fully covers the estimated cost of elective 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
  elective abortion.
         (c)  A health benefit plan issuer may not provide a premium
  discount to or reduce the premium for an enrollee for other health
  benefit plan coverage on the basis that the enrollee has coverage
  for elective abortion.
         Sec. 1218.006.  NOTICE BY ISSUER. A health benefit plan
  issuer that provides coverage for elective abortion shall at the
  time of enrollment in other health benefit plan coverage provide
  each enrollee with a notice that:
               (1)  coverage for elective 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 elective
  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
  without obtaining coverage for elective 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 April
  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 April 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 December 1, 2017.
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