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.