Texas 2017 - 85th Regular

Texas Senate Bill SB20 Compare Versions

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1	1	By: Taylor of Galveston, et al. S.B. No. 20
2	2	(Smithee)
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) This section does not prevent a person from purchasing
35	35	optional or supplemental coverage for abortions under a health
36	36	benefit plan other than a qualified health plan offered through a
37	37	health benefit exchange.
38	38	SECTION 2. Subtitle A, Title 8, Insurance Code, is amended
39	39	by adding Chapter 1218 to read as follows:
40	40	CHAPTER 1218. COVERAGE FOR ABORTION; PROHIBITIONS AND REQUIREMENTS
41	41	Sec. 1218.001. DEFINITIONS. In this chapter, "abortion"
42	42	and "medical emergency" have the meanings assigned by Section
43	43	171.002, Health and Safety Code.
44	44	Sec. 1218.002. APPLICABILITY OF CHAPTER. (a) This chapter
45	45	applies only to a health benefit plan that provides benefits for
46	46	medical or surgical expenses incurred as a result of a health
47	47	condition, accident, or sickness, including an individual, group,
48	48	blanket, or franchise insurance policy or insurance agreement, a
49	49	group hospital service contract, or an individual or group evidence
50	50	of coverage or similar coverage document that is offered by:
51	51	(1) an insurance company;
52	52	(2) a group hospital service corporation operating
53	53	under Chapter 842;
54	54	(3) a fraternal benefit society operating under
55	55	Chapter 885;
56	56	(4) a stipulated premium company operating under
57	57	Chapter 884;
58	58	(5) an exchange operating under Chapter 942;
59	59	(6) a health maintenance organization operating under
60	60	Chapter 843;
61	61	(7) a multiple employer welfare arrangement that holds
62	62	a certificate of authority under Chapter 846; or
63	63	(8) an approved nonprofit health corporation that
64	64	holds a certificate of authority under Chapter 844.
65	65	(b) This chapter applies to group health coverage made
66	66	available by a school district in accordance with Section 22.004,
67	67	Education Code.
68	68	(c) Notwithstanding any provision in Chapter 1551, 1575,
69	69	1579, or 1601 or any other law, this chapter applies to:
70	70	(1) a basic coverage plan under Chapter 1551;
71	71	(2) a basic plan under Chapter 1575;
72	72	(3) a primary care coverage plan under Chapter 1579;
73	73	and
74	74	(4) basic coverage under Chapter 1601.
75	75	(d) Notwithstanding Section 1501.251 or any other law, this
76	76	chapter applies to coverage under a small or large employer health
77	77	benefit plan subject to Chapter 1501.
78	78	(e) Notwithstanding Section 1507.003 or 1507.053, this
79	79	chapter applies to a standard health benefit plan provided under
80	80	Chapter 1507.
81	81	Sec. 1218.003. COVERAGE BY HEALTH BENEFIT PLAN. A health
82	82	benefit plan may provide coverage for abortion only if:
83	83	(1) the coverage is provided to an enrollee separately
84	84	from other health benefit plan coverage offered by the health
85	85	benefit plan issuer;
86	86	(2) an enrollee pays separately from, and in addition
87	87	to, the premium for other health benefit plan coverage a premium for
88	88	coverage for abortion;
89	89	(3) an enrollee provides a signature for coverage for
90	90	abortion, separately and distinct from the signature required for
91	91	other health benefit plan coverage offered by the health benefit
92	92	plan issuer; or
93	93	(4) the coverage provides benefits only for an
94	94	abortion performed due to a medical emergency.
95	95	Sec. 1218.004. CALCULATION OF PREMIUM. (a) A health
96	96	benefit plan issuer that provides coverage for abortion shall
97	97	calculate the premium for the coverage so that the premium fully
98	98	covers the estimated cost of abortion per enrollee, determined on
99	99	an actuarial basis.
100	100	(b) In calculating a premium under Subsection (a), the
101	101	health benefit plan issuer may not take into account any cost
102	102	savings in other health benefit plan coverage offered by the health
103	103	benefit plan issuer that is estimated to result from coverage for
104	104	abortion.
105	105	(c) A health benefit plan issuer that provides coverage
106	106	other than coverage for abortion may not provide a premium discount
107	107	to or reduce the premium for an enrollee for coverage other than
108	108	coverage for abortion on the basis that the enrollee has health
109	109	benefit plan coverage for abortion.
110	110	Sec. 1218.005. NOTICE BY ISSUER. A health benefit plan
111	111	issuer that provides coverage for abortion shall at the time of
112	112	enrollment in the health benefit plan provide each enrollee with a
113	113	notice that:
114	114	(1) coverage for abortion is optional and separate
115	115	from other health benefit plan coverage offered by the health
116	116	benefit plan issuer;
117	117	(2) the premium cost for coverage for abortion is a
118	118	premium paid separately from, and in addition to, the premium for
119	119	other health benefit plan coverage offered by the health benefit
120	120	plan issuer; and
121	121	(3) the enrollee may enroll in a health benefit plan
122	122	that provides coverage other than coverage for abortion without
123	123	obtaining coverage for abortion.
124	124	SECTION 3. This Act applies only to a qualified health plan
125	125	offered through a health benefit exchange or a health benefit plan
126	126	that is delivered, issued for delivery, or renewed on or after
127	127	January 1, 2018. A qualified health plan offered through a health
128	128	benefit exchange or a health benefit plan that is delivered, issued
129	129	for delivery, or renewed before January 1, 2018, is governed by the
130	130	law as it existed immediately before the effective date of this Act,
131	131	and that law is continued in effect for that purpose.
132	132	SECTION 4. This Act takes effect September 1, 2017.