By: Howard H.B. No. 4389
A BILL TO BE ENTITLED
AN ACT
relating to repealing or replacing medically unnecessary and
outdated abortion restrictions.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. This Act may be cited as the Abortion is Health
Care Act.
(b) The legislature finds that:
(1) comprehensive reproductive health care, including
safe abortion, is a vital component of a person's overall health and
of their social and economic equality;
(2) abortion is one of the safest medical procedures
in the United States, as demonstrated by available data, including
from the federal Centers for Disease Control and Prevention,
showing abortion has a more than 99 percent safety record;
(3) any regulation of medical care must have a
legitimate purpose and advance the goals of improving the quality
of care and increasing access to care;
(4) according to the American College of Obstetricians
and Gynecologists, American Medical Association, American Academy
of Family Physicians, and American Osteopathic Association,
"[w]omen's access to high-quality, evidence-based abortion care
should not be limited by laws enacted under the guise of patient
safety but that, in fact, harm women's health"; and
(5) the 334 restrictions on abortion providers and
their patients adopted nationally since 2011 and the onerous
restrictions enacted in this state based on pretextual reasons are
a systematic attempt to eliminate access to safe and legal medical
care.
SECTION 2. The following provisions are repealed:
(1) Chapter 33, Family Code;
(2) Sections 151.002(c), (d), (e), (f), and (g),
Family Code;
(3) Section 32.005, Health and Safety Code;
(4) Sections 171.002(3) and (4), Health and Safety
Code;
(5) Section 171.0031, Health and Safety Code;
(6) Section 171.004, Health and Safety Code;
(7) Section 171.005, Health and Safety Code;
(8) Section 171.006, Health and Safety Code, as added
by Chapter 4 (H.B. 13), Acts of the 85th Legislature, First Called
Session, 2017;
(9) Section 171.006, Health and Safety Code, as added
by Chapter 9 (H.B. 215), Acts of the 85th Legislature, First Called
Session, 2017;
(10) Section 171.012, Health and Safety Code;
(11) Section 171.0121, Health and Safety Code;
(12) Section 171.0122, Health and Safety Code;
(13) Section 171.0123, Health and Safety Code;
(14) Section 171.0124, Health and Safety Code;
(15) Section 171.013, Health and Safety Code;
(16) Section 171.014, Health and Safety Code;
(17) Section 171.015, Health and Safety Code;
(18) Section 171.016, Health and Safety Code;
(19) Section 171.017, Health and Safety Code;
(20) Section 171.018, Health and Safety Code;
(21) Subchapters C, D, F, and G, Chapter 171, Health
and Safety Code;
(22) Section 241.007, Health and Safety Code;
(23) Section 243.017, Health and Safety Code;
(24) Section 245.010, Health and Safety Code;
(25) Section 245.011(f) and (g), Health and Safety
Code;
(26) Section 245.0116, Health and Safety Code;
(27) Section 245.024, Health and Safety Code;
(28) Chapter 697, Health and Safety Code;
(29) Section 32.024(c-1), Human Resources Code;
(30) Chapter 1218, Insurance Code;
(31) Chapter 1696, Insurance Code;
(32) Subtitle M, Title 8, Insurance Code;
(33) Chapter 103, Occupations Code;
(34) Section 111.005(c), Occupations Code; and
(35) Section 164.0551, Occupations Code.
SECTION 3. Section 32.003(a), Family Code, is amended to
read as follows:
(a) A child may consent to medical, dental, psychological,
and surgical treatment for the child by a licensed physician or
dentist if the child:
(1) is on active duty with the armed services of the
United States of America;
(2) is:
(A) 16 years of age or older and resides separate
and apart from the child's parents, managing conservator, or
guardian, with or without the consent of the parents, managing
conservator, or guardian and regardless of the duration of the
residence; and
(B) managing the child's own financial affairs,
regardless of the source of the income;
(3) consents to the diagnosis and treatment of an
infectious, contagious, or communicable disease that is required by
law or a rule to be reported by the licensed physician or dentist to
a local health officer or the Texas Department of Health, including
all diseases within the scope of Section 81.041, Health and Safety
Code;
(4) is unmarried and pregnant and consents to
hospital, medical, or surgical treatment[, other than abortion,]
related to the pregnancy;
(5) consents to examination and treatment for drug or
chemical addiction, drug or chemical dependency, or any other
condition directly related to drug or chemical use;
(6) is unmarried, is the parent of a child, and has
actual custody of his or her child and consents to medical, dental,
psychological, or surgical treatment for the child; or
(7) is serving a term of confinement in a facility
operated by or under contract with the Texas Department of Criminal
Justice[, unless the treatment would constitute a prohibited
practice under Section 164.052(a)(19), Occupations Code].
SECTION 4. The heading to Section 151.002, Family Code, is
amended to read as follows:
Sec. 151.002. RIGHTS OF A LIVING CHILD AFTER AN ABORTION OR
PREMATURE BIRTH[; CIVIL PENALTY; CRIMINAL OFFENSE].
SECTION 5. Section 266.010(a), Family Code, is amended to
read as follows:
(a) A foster child who is at least 16 years of age may
consent to the provision of medical care[, except as provided by
Chapter 33,] if the court with continuing jurisdiction determines
that the child has the capacity to consent to medical care. If the
child provides consent by signing a consent form, the form must be
written in language the child can understand.
SECTION 6. Section 501.065, Government Code, is amended to
read as follows:
Sec. 501.065. CONSENT TO MEDICAL, DENTAL, PSYCHOLOGICAL,
AND SURGICAL TREATMENT. An inmate who is younger than 18 years of
age and is confined in a facility operated by or under contract with
the department may, in accordance with procedures established by
the department, consent to medical, dental, psychological, and
surgical treatment for the inmate by a licensed health care
practitioner, or a person under the direction of a licensed health
care practitioner[, unless the treatment would constitute a
prohibited practice under Section 164.052(a)(19), Occupations
Code].
SECTION 7. Section 2272.002(b), Government Code, as added
by Chapter 501 (S.B. 22), Acts of the 86th Legislature, Regular
Session, 2019, is amended to read as follows:
(b) For purposes of this chapter, a facility is not
considered to be an abortion provider solely based on the
performance of an abortion at the facility during a medical
emergency [as defined by Section 171.002, Health and Safety Code].
In this subsection, "medical emergency" means a life-threatening
physical condition aggravated by, caused by, or arising from a
pregnancy that, as certified by a physician, places the woman in
danger of death or a serious risk of substantial impairment of a
major bodily function unless an abortion is performed.
SECTION 8. Section 171.003, Health and Safety Code, is
amended to read as follows:
Sec. 171.003. PERSONS AUTHORIZED [PHYSICIAN] TO PERFORM OR
INDUCE ABORTION. An abortion may be performed or induced only by:
(1) a physician licensed to practice medicine in this
state;
(2) a nurse licensed under Subtitle E, Title 3,
Occupations Code, who is operating within the nurse's scope of
practice; or
(3) a physician assistant licensed under Chapter 204,
Occupations Code, who is operating within the physician assistant's
scope of practice.
SECTION 9. Section 245.002, Health and Safety Code, is
amended by amending Subdivision (1) and adding Subdivision (3) to
read as follows:
(1) "Abortion" means an act or procedure performed
after pregnancy has been medically verified and with the intent to
cause the termination of a pregnancy other than for the purpose of
either the birth of a live fetus or the removal of a dead fetus [the
act of using or prescribing an instrument, a drug, a medicine, or
any other substance, device, or means with the intent to cause the
death of an unborn child of a woman known to be pregnant]. The term
does not include birth control devices or oral contraceptives. [An
act is not an abortion if the act is done with the intent to:
[(A) save the life or preserve the health of an
unborn child;
[(B) remove a dead, unborn child whose death was
caused by spontaneous abortion; or
[(C) remove an ectopic pregnancy.]
(3) "Commission" means the Health and Human Services
Commission.
SECTION 10. Section 245.005(e), Health and Safety Code, is
amended to read as follows:
(e) As a condition for renewal of a license, the licensee
must submit to the commission [department] the annual license
renewal fee and an annual report, including the report required
under Section 245.011.
SECTION 11. Section 245.006(a), Health and Safety Code, is
amended to read as follows:
(a) The department shall inspect an abortion facility at
random, unannounced, and reasonable times as necessary to ensure
compliance with this chapter and Section 171.011 [, Subchapter B,
Chapter 171, and Chapter 33, Family Code].
SECTION 12. The heading to Section 245.010, Health and
Safety Code, is amended to read as follows:
Sec. 245.010. PERSONS AUTHORIZED TO PERFORM OR INDUCE
ABORTION [MINIMUM STANDARDS].
SECTION 13. Section 245.010(b), Health and Safety Code, is
amended to read as follows:
(b) Only the following persons may perform or induce an
abortion:
(1) a physician as defined by Subtitle B, Title 3,
Occupations Code;
(2) a nurse licensed under Subtitle E, Title 3,
Occupations Code, who is operating within the nurse's scope of
practice; or
(3) a physician assistant licensed under Chapter 204,
Occupations Code, who is operating within the physician assistant's
scope of practice [, may perform an abortion].
SECTION 14. Sections 245.011(a) and (b), Health and Safety
Code, are amended to read as follows:
(a) Each [A physician who performs an abortion at an]
abortion facility must [complete and] submit a monthly report to
the commission [department] on each abortion performed [by the
physician] at the abortion facility. The report must be submitted
on a form provided by the commission [department].
(b) The report may not identify by any means the person
performing the abortion or the patient.
SECTION 15. Section 164.052(a), Occupations Code, is
amended to read as follows:
(a) A physician or an applicant for a license to practice
medicine commits a prohibited practice if that person:
(1) submits to the board a false or misleading
statement, document, or certificate in an application for a
license;
(2) presents to the board a license, certificate, or
diploma that was illegally or fraudulently obtained;
(3) commits fraud or deception in taking or passing an
examination;
(4) uses alcohol or drugs in an intemperate manner
that, in the board's opinion, could endanger a patient's life;
(5) commits unprofessional or dishonorable conduct
that is likely to deceive or defraud the public, as provided by
Section 164.053, or injure the public;
(6) uses an advertising statement that is false,
misleading, or deceptive;
(7) advertises professional superiority or the
performance of professional service in a superior manner if that
advertising is not readily subject to verification;
(8) purchases, sells, barters, or uses, or offers to
purchase, sell, barter, or use, a medical degree, license,
certificate, or diploma, or a transcript of a license, certificate,
or diploma in or incident to an application to the board for a
license to practice medicine;
(9) alters, with fraudulent intent, a medical license,
certificate, or diploma, or a transcript of a medical license,
certificate, or diploma;
(10) uses a medical license, certificate, or diploma,
or a transcript of a medical license, certificate, or diploma that
has been:
(A) fraudulently purchased or issued;
(B) counterfeited; or
(C) materially altered;
(11) impersonates or acts as proxy for another person
in an examination required by this subtitle for a medical license;
(12) engages in conduct that subverts or attempts to
subvert an examination process required by this subtitle for a
medical license;
(13) impersonates a physician or permits another to
use the person's license or certificate to practice medicine in
this state;
(14) directly or indirectly employs a person whose
license to practice medicine has been suspended, canceled, or
revoked;
(15) associates in the practice of medicine with a
person:
(A) whose license to practice medicine has been
suspended, canceled, or revoked; or
(B) who has been convicted of the unlawful
practice of medicine in this state or elsewhere;
(16) performs or procures a criminal abortion, aids or
abets in the procuring of a criminal abortion, attempts to perform
or procure a criminal abortion, or attempts to aid or abet the
performance or procurement of a criminal abortion;
(17) directly or indirectly aids or abets the practice
of medicine by a person, partnership, association, or corporation
that is not licensed to practice medicine by the board;
(18) performs an abortion on a pregnant patient
[woman] who is pregnant with a viable [unborn child] fetus during
the third trimester of the pregnancy unless:
(A) the abortion is necessary to protect the
health or prevent the death of the pregnant patient [woman];
(B) the [viable] fetus [unborn child] has a
severe, irreversible brain impairment; or
(C) the pregnant patient [woman] is diagnosed
with a significant likelihood of suffering imminent severe,
irreversible brain damage or imminent severe, irreversible
paralysis; or
(19) [performs an abortion on an unemancipated minor
without the written consent of the child's parent, managing
conservator, or legal guardian or without a court order, as
provided by Section 33.003 or 33.004, Family Code, unless the
abortion is necessary due to a medical emergency, as defined by
Section 171.002, Health and Safety Code;
[(20) otherwise performs an abortion on an
unemancipated minor in violation of Chapter 33, Family Code;
[(21) performs or induces or attempts to perform or
induce an abortion in violation of Subchapter C, F, or G, Chapter
171, Health and Safety Code; or
[(22)] in complying with the procedures outlined in
Sections 166.045 and 166.046, Health and Safety Code, wilfully
fails to make a reasonable effort to transfer a patient to a
physician who is willing to comply with a directive.
SECTION 16. Section 164.055(b), Occupations Code, is
amended to read as follows:
(b) The sanctions provided by Subsection (a) are in addition
to any other grounds for refusal to admit persons to examination
under this subtitle or to issue a license or renew a license to
practice medicine under this subtitle. The criminal penalties
provided by Section 165.152 do not apply to a violation of Section
170.002, Health and Safety Code[, or Subchapter C, F, or G, Chapter
171, Health and Safety Code].
SECTION 17. The changes in law made by this Act apply only
to an abortion performed or induced on or after the effective date
of this Act. An abortion performed or induced before the effective
date of this Act is governed by the law applicable to the abortion
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
SECTION 18. This Act takes effect September 1, 2021.