Texas 2015 - 84th Regular

Texas Senate Bill SB575 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	84R32467 E
2	2	By: Taylor of Galveston, et al. S.B. No. 575
3	3	(Farney)
4	4	Substitute the following for S.B. No. 575: No.
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to health plan and health benefit plan coverage for
10	10	abortions.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Title 8, Insurance Code, is amended by adding
13	13	Subtitle L to read as follows:
14	14	SUBTITLE L. FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT
15	15	CHAPTER 1691. LEGISLATIVE CONSIDERATIONS
16	16	Sec. 1691.001. CONSTITUTIONALITY OF PATIENT PROTECTION AND
17	17	AFFORDABLE CARE ACT. This subtitle does not constitute an
18	18	acknowledgment by the legislature of the legitimacy of the Patient
19	19	Protection and Affordable Care Act (Pub. L. No. 111-148) as a
20	20	constitutional exercise of the power of the United States Congress.
21	21	CHAPTER 1692. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
22	22	Sec. 1692.001. DEFINITIONS. In this chapter:
23	23	(1) "Abortion" and "medical emergency" have the
24	24	meanings assigned by Section 171.002, Health and Safety Code.
25	25	(2) "Health benefit exchange" means an American Health
26	26	Benefit Exchange administered by the federal government or created
27	27	under Section 1311(b) of the Patient Protection and Affordable Care
28	28	Act (42 U.S.C. Section 18031(b)).
29	29	(3) "Qualified health plan" has the meaning assigned
30	30	by Section 1301(a) of the Patient Protection and Affordable Care
31	31	Act (42 U.S.C. Section 18021(a)).
32	32	Sec. 1692.002. PROHIBITED COVERAGE THROUGH HEALTH BENEFIT
33	33	EXCHANGE. (a) A qualified health plan offered through a health
34	34	benefit exchange may not provide coverage for an abortion other
35	35	than coverage for an abortion performed due to a medical emergency.
36	36	(b) Subsection (a) does not authorize coverage for an
37	37	abortion based on a potential future medical condition that may
38	38	result from a voluntary act of the woman or minor.
39	39	(c) This section does not prevent a person from purchasing
40	40	optional or supplemental coverage for abortions under a health
41	41	benefit plan other than a qualified health plan offered through a
42	42	health benefit exchange.
43	43	SECTION 2. Subtitle A, Title 8, Insurance Code, is amended
44	44	by adding Chapter 1218 to read as follows:
45	45	CHAPTER 1218. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
46	46	Sec. 1218.001. DEFINITIONS. In this chapter, "abortion"
47	47	and "medical emergency" have the meanings assigned by Section
48	48	171.002, Health and Safety Code.
49	49	Sec. 1218.002. APPLICABILITY OF CHAPTER. (a) This chapter
50	50	applies only to a health benefit plan described by Subsection (b) or
51	51	(c).
52	52	(b) This chapter applies to group health coverage made
53	53	available by a school district in accordance with Section 22.004,
54	54	Education Code.
55	55	(c) 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) A
63	63	health benefit plan may provide coverage for abortion only if:
64	64	(1) the coverage is provided to an enrollee separately
65	65	from other health benefit plan coverage offered by the health
66	66	benefit plan issuer;
67	67	(2) an enrollee pays separately from, and in addition
68	68	to, the premium for other health benefit plan coverage a premium for
69	69	coverage for abortion;
70	70	(3) an enrollee provides a signature for coverage for
71	71	abortion, separately and distinct from the signature required for
72	72	other health benefit plan coverage offered by the health benefit
73	73	plan issuer; or
74	74	(4) the coverage provides benefits only for an
75	75	abortion performed due to a medical emergency.
76	76	(b) Subsection (a)(4) does not authorize coverage for an
77	77	abortion based on a potential future medical condition that may
78	78	result from a voluntary act of the enrollee.
79	79	Sec. 1218.004. CALCULATION OF PREMIUM. (a) A health
80	80	benefit plan issuer that provides coverage for abortion shall
81	81	calculate the premium for the coverage so that the premium fully
82	82	covers the estimated cost of abortion per enrollee, determined on
83	83	an average actuarial basis.
84	84	(b) In calculating a premium under Subsection (a), the
85	85	health benefit plan issuer may not take into account any cost
86	86	savings in other health benefit plan coverage offered by the health
87	87	benefit plan issuer that is estimated to result from coverage for
88	88	abortion, including costs associated with prenatal care, delivery,
89	89	or postnatal care.
90	90	(c) A health benefit plan issuer that provides coverage
91	91	other than coverage for abortion may not provide a premium discount
92	92	to or reduce the premium for an enrollee for coverage other than
93	93	coverage for abortion on the basis that the enrollee has health
94	94	benefit plan coverage for abortion.
95	95	Sec. 1218.005. NOTICE BY ISSUER. A health benefit plan
96	96	issuer that provides coverage for abortion shall at the time of
97	97	enrollment in the health benefit plan provide each enrollee with a
98	98	notice that:
99	99	(1) coverage for abortion is optional and separate
100	100	from other health benefit plan coverage offered by the health
101	101	benefit plan issuer;
102	102	(2) the premium cost for coverage for abortion is a
103	103	premium paid separately from, and in addition to, the premium for
104	104	other health benefit plan coverage offered by the health benefit
105	105	plan issuer; and
106	106	(3) the enrollee may enroll in a health benefit plan
107	107	that provides coverage other than coverage for abortion without
108	108	obtaining coverage for abortion.
109	109	Sec. 1218.006. ACCEPTANCE OR REJECTION OF SUPPLEMENTAL
110	110	COVERAGE BY EMPLOYEES AND GROUP MEMBERS. If a health benefit plan
111	111	offers coverage for abortion, the employer or entity offering the
112	112	health benefit plan shall provide each employee or group member
113	113	with an opportunity to accept or reject supplemental coverage for
114	114	abortion:
115	115	(1) at the beginning of employment or when the group
116	116	member's coverage begins, as applicable; and
117	117	(2) at least one time in each calendar year after the
118	118	first year of employment or group coverage.
119	119	SECTION 3. This Act applies only to a qualified health plan
120	120	offered through a health benefit exchange or a health benefit plan
121	121	that is delivered, issued for delivery, or renewed on or after
122	122	January 1, 2016. A qualified health plan offered through a health
123	123	benefit exchange or a health benefit plan that is delivered, issued
124	124	for delivery, or renewed before January 1, 2016, is governed by the
125	125	law as it existed immediately before the effective date of this Act,
126	126	and that law is continued in effect for that purpose.
127	127	SECTION 4. This Act takes effect September 1, 2015.