Texas 2017 - 85th Regular

Texas House Bill HB1113 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	85R2504 SCL-F
2	2	By: Smithee H.B. No. 1113
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to health plan and health benefit plan coverage for
8	8	abortions.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Title 8, Insurance Code, is amended by adding
11	11	Subtitle M to read as follows:
12	12	SUBTITLE M. FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT
13	13	CHAPTER 1695. LEGISLATIVE CONSIDERATIONS
14	14	Sec. 1695.001. CONSTITUTIONALITY OF PATIENT PROTECTION AND
15	15	AFFORDABLE CARE ACT. This subtitle does not constitute an
16	16	acknowledgment by the legislature of the legitimacy of the Patient
17	17	Protection and Affordable Care Act (Pub. L. No. 111-148) as a
18	18	constitutional exercise of the power of the United States Congress.
19	19	CHAPTER 1696. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
20	20	Sec. 1696.001. DEFINITIONS. In this chapter:
21	21	(1) "Abortion" and "medical emergency" have the
22	22	meanings assigned by Section 171.002, Health and Safety Code.
23	23	(2) "Health benefit exchange" means an American Health
24	24	Benefit Exchange administered by the federal government or created
25	25	under Section 1311(b) of the Patient Protection and Affordable Care
26	26	Act (42 U.S.C. Section 18031(b)).
27	27	(3) "Qualified health plan" has the meaning assigned
28	28	by Section 1301(a) of the Patient Protection and Affordable Care
29	29	Act (42 U.S.C. Section 18021(a)).
30	30	Sec. 1696.002. PROHIBITED COVERAGE THROUGH HEALTH BENEFIT
31	31	EXCHANGE. (a) A qualified health plan offered through a health
32	32	benefit exchange may not provide coverage for an abortion other
33	33	than coverage for an abortion performed due to a medical emergency.
34	34	(b) Subsection (a) does not authorize coverage for an
35	35	abortion based on a potential future medical condition that may
36	36	result from a voluntary act of the woman or minor.
37	37	(c) This section does not prevent a person from purchasing
38	38	optional or supplemental coverage for abortions under a health
39	39	benefit plan other than a qualified health plan offered through a
40	40	health benefit exchange.
41	41	SECTION 2. Subtitle A, Title 8, Insurance Code, is amended
42	42	by adding Chapter 1218 to read as follows:
43	43	CHAPTER 1218. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
44	44	Sec. 1218.001. DEFINITIONS. In this chapter, "abortion"
45	45	and "medical emergency" have the meanings assigned by Section
46	46	171.002, Health and Safety Code.
47	47	Sec. 1218.002. APPLICABILITY OF CHAPTER. (a) This chapter
48	48	applies only to a health benefit plan that provides benefits for
49	49	medical or surgical expenses incurred as a result of a health
50	50	condition, accident, or sickness, including an individual, group,
51	51	blanket, or franchise insurance policy or insurance agreement, a
52	52	group hospital service contract, or an individual or group evidence
53	53	of coverage or similar coverage document that is offered by:
54	54	(1) an insurance company;
55	55	(2) a group hospital service corporation operating
56	56	under Chapter 842;
57	57	(3) a fraternal benefit society operating under
58	58	Chapter 885;
59	59	(4) a stipulated premium company operating under
60	60	Chapter 884;
61	61	(5) an exchange operating under Chapter 942;
62	62	(6) a health maintenance organization operating under
63	63	Chapter 843;
64	64	(7) a multiple employer welfare arrangement that holds
65	65	a certificate of authority under Chapter 846; or
66	66	(8) an approved nonprofit health corporation that
67	67	holds a certificate of authority under Chapter 844.
68	68	(b) This chapter applies to group health coverage made
69	69	available by a school district in accordance with Section 22.004,
70	70	Education Code.
71	71	(c) Notwithstanding any provision in Chapter 1551, 1575,
72	72	1579, or 1601 or any other law, this chapter applies to:
73	73	(1) a basic coverage plan under Chapter 1551;
74	74	(2) a basic plan under Chapter 1575;
75	75	(3) a primary care coverage plan under Chapter 1579;
76	76	and
77	77	(4) basic coverage under Chapter 1601.
78	78	(d) Notwithstanding Section 1501.251 or any other law, this
79	79	chapter applies to coverage under a small or large employer health
80	80	benefit plan subject to Chapter 1501.
81	81	(e) Notwithstanding Section 1507.003 or 1507.053, this
82	82	chapter applies to a standard health benefit plan provided under
83	83	Chapter 1507.
84	84	Sec. 1218.003. COVERAGE BY HEALTH BENEFIT PLAN. (a) A
85	85	health benefit plan may provide coverage for abortion only if:
86	86	(1) the coverage is provided to an enrollee separately
87	87	from other health benefit plan coverage offered by the health
88	88	benefit plan issuer;
89	89	(2) an enrollee pays separately from, and in addition
90	90	to, the premium for other health benefit plan coverage a premium for
91	91	coverage for abortion;
92	92	(3) an enrollee provides a signature for coverage for
93	93	abortion, separately and distinct from the signature required for
94	94	other health benefit plan coverage offered by the health benefit
95	95	plan issuer; or
96	96	(4) the coverage provides benefits only for an
97	97	abortion performed due to a medical emergency.
98	98	(b) Subsection (a)(4) does not authorize coverage for an
99	99	abortion based on a potential future medical condition that may
100	100	result from a voluntary act of the enrollee.
101	101	Sec. 1218.004. CALCULATION OF PREMIUM. (a) A health
102	102	benefit plan issuer that provides coverage for abortion shall
103	103	calculate the premium for the coverage so that the premium fully
104	104	covers the estimated cost of abortion per enrollee, determined on
105	105	an average actuarial basis.
106	106	(b) In calculating a premium under Subsection (a), the
107	107	health benefit plan issuer may not take into account any cost
108	108	savings in other health benefit plan coverage offered by the health
109	109	benefit plan issuer that is estimated to result from coverage for
110	110	abortion, including costs associated with prenatal care, delivery,
111	111	or postnatal care.
112	112	(c) A health benefit plan issuer that provides coverage
113	113	other than coverage for abortion may not provide a premium discount
114	114	to or reduce the premium for an enrollee for coverage other than
115	115	coverage for abortion on the basis that the enrollee has health
116	116	benefit plan coverage for abortion.
117	117	Sec. 1218.005. NOTICE BY ISSUER. A health benefit plan
118	118	issuer that provides coverage for abortion shall at the time of
119	119	enrollment in the health benefit plan provide each enrollee with a
120	120	notice that:
121	121	(1) coverage for abortion is optional and separate
122	122	from other health benefit plan coverage offered by the health
123	123	benefit plan issuer;
124	124	(2) the premium cost for coverage for abortion is a
125	125	premium paid separately from, and in addition to, the premium for
126	126	other health benefit plan coverage offered by the health benefit
127	127	plan issuer; and
128	128	(3) the enrollee may enroll in a health benefit plan
129	129	that provides coverage other than coverage for abortion without
130	130	obtaining coverage for abortion.
131	131	Sec. 1218.006. ACCEPTANCE OR REJECTION OF SUPPLEMENTAL
132	132	COVERAGE BY EMPLOYEES AND GROUP MEMBERS. If a small or large
133	133	employer health benefit plan or group health benefit plan offers
134	134	coverage for abortion, the employer offering the employer health
135	135	benefit plan or the entity offering the group health benefit plan
136	136	shall provide each employee or group member with an opportunity to
137	137	accept or reject supplemental coverage for abortion:
138	138	(1) at the beginning of employment or when the group
139	139	member's coverage begins, as applicable; and
140	140	(2) at least one time in each calendar year after the
141	141	first year of employment or group coverage.
142	142	SECTION 3. This Act applies only to a qualified health plan
143	143	offered through a health benefit exchange or a health benefit plan
144	144	that is delivered, issued for delivery, or renewed on or after
145	145	January 1, 2018. A qualified health plan offered through a health
146	146	benefit exchange or a health benefit plan that is delivered, issued
147	147	for delivery, or renewed before January 1, 2018, is governed by the
148	148	law as it existed immediately before the effective date of this Act,
149	149	and that law is continued in effect for that purpose.
150	150	SECTION 4. This Act takes effect September 1, 2017.