Texas 2021 - 87th Regular

Texas House Bill HB2337 Compare Versions

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Old	New		Differences
1		-	87R19575 SCL-F
2		-	By: Klick, Noble, Oliverson, Bonnen, Frank, H.B. No. 2337
3		-	et al.
4		-	Substitute the following for H.B. No. 2337:
5		-	By: Klick C.S.H.B. No. 2337
	1	+	87R12396 TYPED
	2	+	By: Klick H.B. No. 2337
6	3
7	4
8	5		A BILL TO BE ENTITLED
9	6		AN ACT
10		-	relating to abortion complication reporting and the regulation of
11		-	drug-induced abortion procedures, providers, and facilities;
12		-	creating a criminal offense.
	7	+	relating to the regulation of drug-induced abortion procedures,
	8	+	providers, and facilities; providing criminal penalties.
13	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
14		-	SECTION 1. The legislature finds that:
15		-	(1) ~~this~~ state has an interest to protect the health
16		-	~~and~~ welfare of every woman considering a drug-induced abortion;
17		-	(2) the use of Mifeprex or mifepristone presents
	10	+	SECTION 1. The Legislature of the State of Texas finds that:
	11	+	(1) The state has an interest to protect the health and
	12	+	welfare of every woman considering a drug-induced abortion.
	13	+	(2) The use of Mifeprex/mifepristone presents
18	14		significant medical complications including, but not limited to,
19	15		uterine hemorrhage, viral infections, abdominal pain, cramping,
20		-	vomiting, headache, fatigue, and pelvic inflammatory disease~~; and~~
	16	+	vomiting, headache, fatigue, and pelvic inflammatory disease.
21	17		(3) The risk of failure rate and complications
22	18		increases with advancing gestational age.
23		-	SECTION 2. Sections 171.006(a) and (b), Health and Safety
24		-	Code, as added by Chapter 4 (H.B. 13), Acts of the 85th Legislature,
25		-	1st Called Session, 2017, are amended to read as follows:
26		-	(a) In this section, "abortion complication" or "adverse
27		-	event" means any harmful event or adverse outcome with respect to a
28		-	patient related to an abortion that is performed or induced on the
29		-	patient and that is diagnosed or treated by a health care
30		-	practitioner or at a health care facility and includes:
31		-	(1) shock;
32		-	(2) uterine perforation;
33		-	(3) cervical laceration;
34		-	(4) hemorrhage;
35		-	(5) aspiration or allergic response;
36		-	(6) infection;
37		-	(7) sepsis;
38		-	(8) death of the patient;
39		-	(9) incomplete abortion;
40		-	(10) damage to the uterus; [or]
41		-	(11) an infant born alive after the abortion;
42		-	(12) blood clots resulting in pulmonary embolism or
43		-	deep vein thrombosis;
44		-	(13) failure to actually terminate the pregnancy;
45		-	(14) pelvic inflammatory disease;
46		-	(15) endometritis;
47		-	(16) missed ectopic pregnancy;
48		-	(17) cardiac arrest;
49		-	(18) respiratory arrest;
50		-	(19) renal failure;
51		-	(20) metabolic disorder;
52		-	(21) embolism;
53		-	(22) coma;
54		-	(23) placenta previa in subsequent pregnancies;
55		-	(24) preterm delivery in subsequent pregnancies;
56		-	(25) fluid accumulation in the abdomen;
57		-	(26) hemolytic reaction resulting from the
58		-	administration of ABO-incompatible blood or blood products;
59		-	(27) adverse reactions to anesthesia or other drugs;
60		-	or
61		-	(28) any other adverse event as defined by the United
62		-	States Food and Drug Administration's criteria provided by the
63		-	MedWatch Reporting System.
64		-	(b) The reporting requirements of this section apply only
65		-	to:
66		-	(1) a physician who:
67		-	(A) performs or induces at an abortion facility
68		-	an abortion that results in an abortion complication diagnosed or
69		-	treated by that physician; or
70		-	(B) diagnoses or treats [at an abortion facility]
71		-	an abortion complication that is the result of an abortion
72		-	performed or induced by another physician [at the facility]; or
73		-	(2) a health care facility that is a hospital,
74		-	abortion facility, freestanding emergency medical care facility,
75		-	or health care facility that provides emergency medical care, as
76		-	defined by Section 773.003.
77		-	SECTION 3. Section 171.061, Health and Safety Code, is
78		-	amended by amending Subdivisions (2) and (5) and adding
79		-	Subdivisions (2-a) and (8-a) to read as follows:
	19	+	SECTION 2. Section 171.061, Health and Safety Code, is
	20	+	amended to read as follows:
	21	+	Sec. 171.061. DEFINITIONS. In this subchapter:
	22	+	(1) "Abortion" has the meaning assigned by Section
	23	+	245.002. This definition, as applied in this subchapter, may not be
	24	+	construed to apply to an act done with the intent to treat a
	25	+	maternal disease or illness for which a prescribed drug, medicine,
	26	+	or other substance is indicated.
80	27		(2) "Abortion-inducing drug" means a drug, a medicine,
81	28		or any other substance, including a regimen of two or more drugs,
82	29		medicines, or substances, prescribed, dispensed, or administered
83	30		with the intent of terminating a clinically diagnosable pregnancy
84	31		of a woman and with knowledge that the termination will, with
85	32		reasonable likelihood, cause the death of the woman's unborn child.
86	33		The term includes off-label use of drugs, medicines, or other
87	34		substances known to have abortion-inducing properties that are
88	35		prescribed, dispensed, or administered with the intent of causing
89	36		an abortion, including the Mifeprex regimen, misoprostol
90	37		(Cytotec), and methotrexate. The term does not include a drug,
91	38		medicine, or other substance that may be known to cause an abortion
92	39		but is prescribed, dispensed, or administered for other medical
93	40		reasons.
94		-	(2-a) "Adverse event" or "abortion complication"
95		-	means any harmful event or adverse outcome with respect to a patient
96		-	related to an abortion, including the abortion complications listed
97		-	in Section 171.006, as added by Chapter 4 (H.B. 13), Acts of the
98		-	85th Legislature, 1st Called Session, 2017.
	41	+	(3) "Final printed label" or "FPL" means the
	42	+	informational document approved by the United States Food and Drug
	43	+	Administration for an abortion-inducing drug that:
	44	+	(A) outlines the protocol authorized by that
	45	+	agency and agreed to by the drug company applying for authorization
	46	+	of the drug by that agency; and
	47	+	(B) delineates how a drug is to be used according
	48	+	to approval by that agency.
	49	+	(3) "Adverse event" means any adverse physical
	50	+	condition arising from the performance of an abortion, including
	51	+	the complications listed in Section 171.006, Health and Safety
	52	+	Code.
	53	+	(4) "Gestational age" means the amount of time that
	54	+	has elapsed since the first day of a woman's last menstrual period.
99	55		(5) "Medical abortion" means the administration or use
100		-	of an abortion-inducing drug to induce an abortion, and may also be
101		-	referred to as a "medication abortion," a "chemical abortion," a
102		-	"drug-induced abortion," "RU-486," or the "Mifeprex regimen".
103		-	(8-a) "Provide" means, when used regarding
	56	+	of an abortion-inducing drug to induce an abortion. The use of such
	57	+	drugs to induce abortion is also known as "medical," "medication,"
	58	+	"RU-486," "chemical," "Mifeprex regimen," or "drug-induced"
	59	+	abortion.
	60	+	(6) "Mifeprex regimen," "RU-486 regimen," or "RU-486"
	61	+	means the abortion-inducing drug regimen approved by the United
	62	+	States Food and Drug Administration that consists of administering
	63	+	mifepristone and misoprostol.
	64	+	(7) (6) "Physician" means an individual who is
	65	+	licensed to practice medicine in this state, including a medical
	66	+	doctor and a doctor of osteopathic medicine.
	67	+	(8)(7) "Pregnant" means the female reproductive
	68	+	condition of having an unborn child in a woman's uterus.
	69	+	(8) "Provide" means, when used regarding
104	70		abortion-inducing drugs, any act of giving, selling, dispensing,
105		-	administering, transferring possession, or otherwise providing or
106		-	prescribing an abortion-inducing drug.
107		-	SECTION 4. Section 171.063, Health and Safety Code, is
108		-	amended by amending Subsections (a), (c), and (e) and adding
109		-	Subsection (b-1) to read as follows:
110		-	(a) A person may not knowingly [give, sell, dispense,
111		-	administer,] provide[, or prescribe] an abortion-inducing drug to a
	71	+	administering, transferring possession to or otherwise providing
	72	+	or prescribing an abortion-inducing drug.
	73	+	(9) "Unborn child" means an offspring of human beings
	74	+	from conception until birth.
	75	+	SECTION 3. Section 171.063, Health and Safety Code, is
	76	+	amended by amending Subsections (a), (b), and (c) to read as
	77	+	follows:
	78	+	(a) A person may not knowingly give, sell, dispense,
	79	+	administer, provide, or prescribe an abortion-inducing drug to a
112	80		pregnant woman for the purpose of inducing an abortion in the
113	81		pregnant woman or enabling another person to induce an abortion in
114	82		the pregnant woman unless:
115		-	(1) the person who [gives, sells, dispenses,
116		-	administers,] provides[, or prescribes] the abortion-inducing drug
117		-	is a physician; and
118		-	(2) [except as otherwise provided by Subsection (b),]
119		-	the provision[, prescription, or administration] of the
120		-	abortion-inducing drug satisfies the protocol [tested and]
121		-	authorized by this subchapter [the United States Food and Drug
122		-	Administration as outlined in the final printed label of the
123		-	abortion-inducing drug].
124		-	(b-1) A manufacturer, supplier, physician, or any other
125		-	person may not provide to a patient any abortion-inducing drug by
126		-	courier, delivery, or mail service.
127		-	(c) Before the physician [gives, sells, dispenses,
128		-	administers,] provides[, or prescribes] an abortion-inducing drug,
	83	+	(1) the person who gives, sells, dispenses,
	84	+	administers, provides, or prescribes the abortion-inducing drug is
	85	+	a physician; and
	86	+	(2) except as otherwise provided by Subsection (b),
	87	+	the provision, prescription, or administration of the
	88	+	abortion-inducing drug satisfies the protocol tested and
	89	+	authorized by the United States Food and Drug Administration as
	90	+	outlined in the final printed label of the abortion-inducing
	91	+	drug the requirements and procedures laid out in this subchapter.
	92	+	(b) A person may provide, prescribe, or administer the
	93	+	abortion-inducing drug in the dosage amount prescribed by the
	94	+	clinical management guidelines defined by the American Congress of
	95	+	Obstetricians and Gynecologists Practice Bulletin as those
	96	+	guidelines existed on January 1, 2013. It shall be unlawful for any
	97	+	manufacturer, supplier, physician, or any other person to provide
	98	+	any abortion-inducing drug via courier, delivery, or mail service.
	99	+	(c) Before the physician gives, sells, dispenses,
	100	+	administers, provides, or prescribes an abortion-inducing drug,
129	101		the physician must:
130		-	(1) examine the pregnant woman in person;
	102	+	(1) examine the pregnant woman in-person;
131	103		(2) independently verify that a pregnancy exists;
132		-	(3) [and] document, in the woman's medical record, the
133		-	gestational age and intrauterine location of the pregnancy to
134		-	determine if an ectopic pregnancy exists;
135		-	(4) determine the pregnant woman's blood type, and for
136		-	a woman who is Rh negative, offer to administer Rh immunoglobulin
137		-	(RhoGAM) at the time the abortion is performed or induced to prevent
138		-	Rh incompatibility, complications, or miscarriage in future
139		-	pregnancies;
140		-	(5) document whether the pregnant woman received
141		-	treatment for Rh negativity, as diagnosed by the most accurate
142		-	standard of medical care; and
143		-	(6) ensure the physician does not provide an
144		-	abortion-inducing drug for a pregnant woman whose pregnancy is more
145		-	than 49 days of gestational age.
146		-	(e) A [The] physician who [gives, sells, dispenses,
147		-	administers,] provides[, or prescribes] the abortion-inducing
148		-	drug, or the physician's agent, must schedule a follow-up visit for
149		-	the woman to occur not later [more] than the 14th day [14 days]
150		-	after the earliest date on which the abortion is performed or
151		-	induced or the drug is administered [administration] or used [use
152		-	of the drug]. At the follow-up visit, the physician must:
153		-	(1) confirm that the woman's pregnancy is completely
154		-	terminated; and
155		-	(2) assess any continued blood loss [the degree of
156		-	bleeding].
157		-	SECTION 5. Subchapter D, Chapter 171, Health and Safety
	104	+	(3) and document, in the woman's medical record, the
	105	+	gestational age and intrauterine location of the pregnancy in order
	106	+	to rule out ectopic pregnancy;,
	107	+	(4) determine the woman's blood type, and if she is Rh
	108	+	negative, be able to and offer to administer Rh immunoglobulin
	109	+	(RhoGAM) at the time of the abortion to prevent Rh incompatibility,
	110	+	complications, or miscarriage in future pregnancies;
	111	+	(5) document whether she received treatment for Rh
	112	+	negativity, as diagnosed by the most accurate standard of medical
	113	+	care; and
	114	+	(6) ensure that they do not give, sell, dispense,
	115	+	administers, provide, or prescribe an abortion-inducing drug for a
	116	+	pregnant woman whose pregnancy is beyond 49 days gestational age.
	117	+	SECTION 4. Subchapter D, Chapter 171, Health and Safety
158	118		Code, is amended by adding Sections 171.0631, 171.0632, 171.065,
159	119		and 171.066 to read as follows:
160		-	Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIRED. A
161		-	person may not provide an abortion-inducing drug to a pregnant
162		-	woman without satisfying the applicable informed consent
163		-	requirements of Subchapter B.
164		-	Sec. 171.0632. REPORTING REQUIREMENTS. A physician who
165		-	provides an abortion-inducing drug must comply with the applicable
166		-	physician reporting requirements under Section 245.011.
167		-	Sec. 171.065. CRIMINAL OFFENSE. (a) A person who
168		-	intentionally, knowingly, or recklessly violates this subchapter
169		-	commits an offense. An offense under this subsection is a state
170		-	jail felony.
171		-	(b) A pregnant woman on whom a drug-induced abortion is
172		-	attempted, induced, or performed in violation of this subchapter is
173		-	not criminally liable for the violation.
174		-	(c) Conduct constituting an offense under this section may
175		-	also be the basis for an administrative violation under Section
176		-	171.064.
177		-	Sec. 171.066. ENFORCEMENT OF SUBCHAPTER. A state executive
178		-	or administrative official may not decline to enforce this
179		-	subchapter, or adopt a construction of this subchapter in a way that
180		-	narrows its applicability, based on the official's own beliefs on
181		-	the requirements of the state or federal constitution, unless the
182		-	official is enjoined by a state or federal court from enforcing this
	120	+	Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIREMENTS
	121	+	FOR ABORTION-INDUCING DRUGS. No abortion-inducing drug shall be
	122	+	provided to a pregnant woman without satisfying the informed
	123	+	consent requirements of Sections 171.011-171.018, Subchapter B,
	124	+	Health and Safety Code, as applicable.
	125	+	Sec. 171.0632. REPORTING ON ABORTION-INDUCING DRUGS AND
	126	+	DRUG-INDUCED ABORTIONS. A physician who gives, sells, dispenses,
	127	+	administers, provides, or prescribes an abortion-inducing drug
	128	+	must comply with the applicable Physician Reporting Requirements in
	129	+	Sec. 245.011, Health and Safety Code.
	130	+	Sec. 171.065. CRIMINAL PENALTY. (a) In addition to
	131	+	penalties permitted under Sec. 171.066, a person who intentionally,
	132	+	knowingly, or recklessly violates any provision of this Act is
	133	+	guilty of a state jail felony. In this Section, "intentionally",
	134	+	"knowingly", and "recklessly," are defined by Section 6.03(a)-(c),
	135	+	Penal Code.
	136	+	(b) No criminal penalty may be assessed against the pregnant
	137	+	woman upon whom the drug-induced abortion is attempted, induced, or
	138	+	performed.
	139	+	Sec. 171.066. CONSTRUCTION. A state executive or
	140	+	administrative official may not decline to enforce this subchapter,
	141	+	or adopt a construction of this subchapter in a way that narrows its
	142	+	applicability, based on the official's own beliefs about what the
	143	+	state or federal constitution requires, unless the official is
	144	+	enjoined by a state or federal court from enforcing this
183	145		subchapter.
184		-	SECTION 6. The following provisions of the Health and
185		-	Safety Code are repealed:
186		-	(1) Sections 171.061(3) and (6); and
187		-	(2) Section 171.063(b).
188		-	SECTION 7. (a) Nothing in this Act shall be construed as
189		-	creating or recognizing a right to abortion.
	146	+	SECTION 5. CONSTRUCTION. (a)Nothing in this Act shall be
	147	+	construed as creating or recognizing a right to abortion.
190	148		(b) It is not the intention of this Act to make lawful an
191	149		abortion that is otherwise unlawful.
192	150		(c) Nothing in this Act repeals, replaces, or otherwise
193	151		invalidates existing Texas laws, regulations, or policies.
194		-	SECTION 8. Any provision of this Act held to be invalid or
195		-	unenforceable by its terms or as applied to any person or
196		-	circumstance shall be construed so as to give the provision the
197		-	maximum effect permitted by law, unless such holding is one of utter
198		-	invalidity or unenforceability, in which event the provision shall
199		-	be considered severable from the other provisions of this Act and
200		-	shall not affect the remainder or the application of the provisions
201		-	to other persons not similarly situated or to other, dissimilar
202		-	circumstances.
203		-	SECTION 9. (a) Except as provided by Subsection (b) of this
204		-	section, the changes in law made by this Act apply only to an
205		-	abortion performed or induced on or after the effective date of this
206		-	Act.
207		-	(b) Section 171.065, Health and Safety Code, as added by
208		-	this Act, applies only to an abortion performed or induced on or
209		-	after September 1, 2021.
210		-	SECTION 10. This Act takes effect immediately if it
211		-	receives a vote of two-thirds of all the members elected to each
212		-	house, as provided by Section 39, Article III, Texas Constitution.
213		-	If this Act does not receive the vote necessary for immediate
214		-	effect, this Act takes effect September 1, 2021.
	152	+	SECTION 6. SEVERABILITY. Any provision of this Act held to
	153	+	be invalid or unenforceable by its terms or as applied to any person
	154	+	or circumstance shall be construed so as to give it the maximum
	155	+	effect permitted by law, unless such holding shall be one of utter
	156	+	invalidity or unenforceability, in which event such provision shall
	157	+	be deemed severable herefrom and shall not affect the remainder
	158	+	hereof or the application of such provision to other persons not
	159	+	similarly situated or to other, dissimilar circumstances.
	160	+	SECTION 7. This Act takes effect immediately if it receives
	161	+	a vote of two-thirds of all the members elected to each house, as
	162	+	provided by Section 39, Article III, Texas Constitution. If this
	163	+	Act does not receive the vote necessary for immediate effect, this
	164	+	Act takes effect September 1, 2021.