Texas 2015 - 84th Regular

Texas House Bill HB3130 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	84R27167 KKR-D
2	2	By: Farney, Morrison, Smithee, Burkett, H.B. No. 3130
3	3	Harless, et al.
4	4	Substitute the following for H.B. No. 3130:
5	5	By: Cook C.S.H.B. No. 3130
6	6
7	7
8	8	A BILL TO BE ENTITLED
9	9	AN ACT
10	10	relating to coverage provided by certain health plans and health
11	11	benefit plans for abortions.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Title 8, Insurance Code, is amended by adding
14	14	Subtitle L to read as follows:
15	15	SUBTITLE L. FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT
16	16	CHAPTER 1692. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
17	17	Sec. 1692.001. DEFINITIONS. In this chapter:
18	18	(1) "Abortion" has the meaning assigned by Section
19	19	171.002, Health and Safety Code.
20	20	(2) "Health benefit exchange" means an American Health
21	21	Benefit Exchange administered by the federal government or created
22	22	under Section 1311(b), Patient Protection and Affordable Care Act
23	23	(42 U.S.C. Section 18031(b)).
24	24	(3) "Qualified health plan" has the meaning assigned
25	25	by Section 1301(a), Patient Protection and Affordable Care Act (42
26	26	U.S.C. Section 18021(a)).
27	27	Sec. 1692.002. PROHIBITED COVERAGE THROUGH HEALTH BENEFIT
28	28	EXCHANGE. (a) A qualified health plan offered through a health
29	29	benefit exchange may not provide coverage for an abortion other
30	30	than coverage for an abortion performed when a life-threatening
31	31	physical condition exists, based on reasonable medical judgment,
32	32	that complicates the medical condition of the pregnant woman or
33	33	pregnant minor to an extent that:
34	34	(1) the immediate abortion of her pregnancy is
35	35	necessary to avert her death; or
36	36	(2) a delay in performing the abortion creates a
37	37	serious risk of substantial and irreversible physical impairment of
38	38	a major bodily function, other than a psychological or emotional
39	39	condition.
40	40	(b) Subsection (a) does not authorize coverage for an
41	41	abortion based on a potential future medical condition that may
42	42	result from a voluntary act of the woman or minor.
43	43	(c) This section does not prevent a person from purchasing
44	44	optional or supplemental coverage for abortion under a health
45	45	benefit plan other than a qualified health plan offered through a
46	46	health benefit exchange.
47	47	SECTION 2. Subtitle A, Title 8, Insurance Code, is amended
48	48	by adding Chapter 1218 to read as follows:
49	49	CHAPTER 1218. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
50	50	Sec. 1218.001. DEFINITION. In this chapter, "abortion" has
51	51	the meaning assigned by Section 171.002, Health and Safety Code.
52	52	Sec. 1218.002. APPLICABILITY OF CHAPTER. (a) This chapter
53	53	applies to group health coverage made available by a school
54	54	district in accordance with Section 22.004, Education Code.
55	55	(b) Notwithstanding any provision in Chapter 1551, 1575,
56	56	1579, or 1601 or any other law, this chapter applies to:
57	57	(1) a basic coverage plan under Chapter 1551;
58	58	(2) a basic plan under Chapter 1575;
59	59	(3) a primary care coverage plan under Chapter 1579;
60	60	and
61	61	(4) basic coverage under Chapter 1601.
62	62	Sec. 1218.003. COVERAGE BY HEALTH BENEFIT PLAN. (a) Except
63	63	as provided by Subsection (b), a health benefit plan may provide
64	64	coverage for abortion only if:
65	65	(1) the coverage is provided to an enrollee separately
66	66	from other health benefit plan coverage offered by the health
67	67	benefit plan issuer;
68	68	(2) an enrollee pays separately from, and in addition
69	69	to, the premium for other health benefit plan coverage a premium for
70	70	coverage for abortion; and
71	71	(3) an enrollee provides a signature for coverage for
72	72	abortion, separately and distinct from the signature required for
73	73	other health benefit plan coverage offered by the health benefit
74	74	plan issuer.
75	75	(b) Notwithstanding Subsection (a), a health benefit plan
76	76	may provide coverage for an abortion performed when a
77	77	life-threatening physical condition exists, based on the
78	78	performing physician's reasonable medical judgment, that
79	79	complicates the medical condition of a pregnant enrollee to the
80	80	extent that the abortion of her pregnancy is necessary to prevent
81	81	her death or a serious risk of substantial and irreversible
82	82	physical impairment of a major bodily function of the enrollee,
83	83	other than a psychological or emotional condition.
84	84	(c) Subsection (b) does not authorize coverage for an
85	85	abortion based on a potential future medical condition that may
86	86	result from a voluntary act of the enrollee.
87	87	Sec. 1218.004. CALCULATION OF PREMIUM. (a) A health
88	88	benefit plan issuer that provides coverage for abortion shall
89	89	calculate the premium for the coverage so that the premium fully
90	90	covers the estimated cost of abortion per enrollee, determined on
91	91	an average actuarial basis.
92	92	(b) In calculating a premium under Subsection (a), the
93	93	health benefit plan issuer may not take into account any cost
94	94	savings in other health benefit plan coverage offered by the health
95	95	benefit plan issuer that is estimated to result from coverage for
96	96	abortion, including costs associated with prenatal care, delivery,
97	97	or postnatal care.
98	98	(c) A health benefit plan issuer that provides coverage
99	99	other than coverage for abortion may not provide a premium discount
100	100	to or reduce the premium for an enrollee for coverage other than
101	101	coverage for abortion on the basis that the enrollee has health
102	102	benefit plan coverage for abortion.
103	103	Sec. 1218.005. NOTICE BY ISSUER. A health benefit plan
104	104	issuer that provides coverage for abortion shall at the time of
105	105	enrollment in the health benefit plan provide each enrollee with a
106	106	notice that:
107	107	(1) coverage for abortion is optional and separate
108	108	from other health benefit plan coverage offered by the health
109	109	benefit plan issuer;
110	110	(2) the premium cost for coverage for abortion is a
111	111	premium paid separately from, and in addition to, the premium for
112	112	other health benefit plan coverage offered by the health benefit
113	113	plan issuer; and
114	114	(3) the enrollee may enroll in a health benefit plan
115	115	that provides coverage other than coverage for abortion without
116	116	obtaining coverage for abortion.
117	117	Sec. 1218.006. ACCEPTANCE OR REJECTION OF SUPPLEMENTAL
118	118	COVERAGE BY EMPLOYEES AND GROUP MEMBERS. Each employee or group
119	119	member participating in a health benefit plan subject to this
120	120	chapter must have an opportunity to accept or reject supplemental
121	121	coverage for abortion:
122	122	(1) at the beginning of employment or when the group
123	123	member's coverage begins, as applicable; and
124	124	(2) at least one time in each calendar year after the
125	125	first year of employment or group coverage.
126	126	SECTION 3. (a) Chapter 1692, Insurance Code, as added by
127	127	this Act, applies only to a qualified health plan offered through a
128	128	health benefit exchange that is delivered, issued for delivery, or
129	129	renewed on or after January 1, 2016. A qualified health plan
130	130	offered through a health benefit exchange that is delivered, issued
131	131	for delivery, or renewed before January 1, 2016, is governed by the
132	132	law as it existed immediately before the effective date of this Act,
133	133	and that law is continued in effect for that purpose.
134	134	(b) Chapter 1218, Insurance Code, as added by this Act,
135	135	applies only to a health benefit plan that is delivered, issued for
136	136	delivery, or renewed for a plan year beginning on or after September
137	137	1, 2015. A health benefit plan that is delivered, issued for
138	138	delivery, or renewed for a plan year beginning before September 1,
139	139	2015, is governed by the law as it existed immediately before the
140	140	effective date of this Act, and that law is continued in effect for
141	141	that purpose.
142	142	SECTION 4. This Act takes effect September 1, 2015.