Texas 2021 - 87th Regular

Texas Senate Bill SB394 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Lucio, et al. S.B. No. 394
2		-	(Klick, Noble, Oliverson, Bonnen, Frank, et al.)
3	2
4	3
5	4		A BILL TO BE ENTITLED
6	5		AN ACT
7	6		relating to abortion complication reporting and the regulation of
8	7		drug-induced abortion procedures, providers, and facilities;
9	8		creating a criminal offense.
10	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	10		SECTION 1. The legislature finds that:
12	11		(1) this state has an interest to protect the health
13	12		and welfare of every woman considering a drug-induced abortion;
14	13		(2) the use of Mifeprex or mifepristone presents
15	14		significant medical complications including, but not limited to,
16	15		uterine hemorrhage, viral infections, abdominal pain, cramping,
17	16		vomiting, headache, fatigue, and pelvic inflammatory disease; and
18	17		(3) the risk of failure rate and complications
19	18		increases with advancing gestational age.
20	19		SECTION 2. Sections 171.006(a) and (b), Health and Safety
21	20		Code, as added by Chapter 4 (H.B. 13), Acts of the 85th Legislature,
22	21		1st Called Session, 2017, are amended to read as follows:
23	22		(a) In this section, "abortion complication" or "adverse
24	23		event" means any harmful event or adverse outcome with respect to a
25	24		patient related to an abortion that is performed or induced on the
26	25		patient and that is diagnosed or treated by a health care
27	26		practitioner or at a health care facility and includes:
28	27		(1) shock;
29	28		(2) uterine perforation;
30	29		(3) cervical laceration;
31	30		(4) hemorrhage;
32	31		(5) aspiration or allergic response;
33	32		(6) infection;
34	33		(7) sepsis;
35	34		(8) death of the patient;
36	35		(9) incomplete abortion;
37	36		(10) damage to the uterus; [or]
38	37		(11) an infant born alive after the abortion;
39	38		(12) blood clots resulting in pulmonary embolism or
40	39		deep vein thrombosis;
41	40		(13) failure to actually terminate the pregnancy;
42	41		(14) pelvic inflammatory disease;
43	42		(15) endometritis;
44	43		(16) missed ectopic pregnancy;
45	44		(17) cardiac arrest;
46	45		(18) respiratory arrest;
47	46		(19) renal failure;
48	47		(20) metabolic disorder;
49	48		(21) embolism;
50	49		(22) coma;
51	50		(23) placenta previa in subsequent pregnancies;
52	51		(24) preterm delivery in subsequent pregnancies;
53	52		(25) fluid accumulation in the abdomen;
54	53		(26) hemolytic reaction resulting from the
55	54		administration of ABO-incompatible blood or blood products;
56	55		(27) adverse reactions to anesthesia or other drugs;
57	56		or
58	57		(28) any other adverse event as defined by the United
59	58		States Food and Drug Administration's criteria provided by the
60	59		MedWatch Reporting System.
61	60		(b) The reporting requirements of this section apply only
62	61		to:
63	62		(1) a physician who:
64	63		(A) performs or induces at an abortion facility
65	64		an abortion that results in an abortion complication diagnosed or
66	65		treated by that physician; or
67	66		(B) diagnoses or treats [at an abortion facility]
68	67		an abortion complication that is the result of an abortion
69	68		performed or induced by another physician [at the facility]; or
70	69		(2) a health care facility that is a hospital,
71	70		abortion facility, freestanding emergency medical care facility,
72	71		or health care facility that provides emergency medical care, as
73	72		defined by Section 773.003.
74	73		SECTION 3. Section 171.061, Health and Safety Code, is
75	74		amended by amending Subdivisions (2) and (5) and adding
76	75		Subdivisions (2-a) and (8-a) to read as follows:
77	76		(2) "Abortion-inducing drug" means a drug, a medicine,
78	77		or any other substance, including a regimen of two or more drugs,
79	78		medicines, or substances, prescribed, dispensed, or administered
80	79		with the intent of terminating a clinically diagnosable pregnancy
81	80		of a woman and with knowledge that the termination will, with
82	81		reasonable likelihood, cause the death of the woman's unborn child.
83	82		The term includes off-label use of drugs, medicines, or other
84	83		substances known to have abortion-inducing properties that are
85	84		prescribed, dispensed, or administered with the intent of causing
86	85		an abortion, including the Mifeprex regimen, misoprostol
87	86		(Cytotec), and methotrexate. The term does not include a drug,
88	87		medicine, or other substance that may be known to cause an abortion
89	88		but is prescribed, dispensed, or administered for other medical
90	89		reasons.
91	90		(2-a) "Adverse event" or "abortion complication"
92	91		means any harmful event or adverse outcome with respect to a patient
93	92		related to an abortion, including the abortion complications listed
94	93		in Section 171.006, as added by Chapter 4 (H.B. 13), Acts of the
95	94		85th Legislature, 1st Called Session, 2017.
96	95		(5) "Medical abortion" means the administration or use
97	96		of an abortion-inducing drug to induce an abortion, and may also be
98	97		referred to as a "medication abortion," a "chemical abortion," a
99	98		"drug-induced abortion," "RU-486," or the "Mifeprex regimen".
100	99		(8-a) "Provide" means, when used regarding
101	100		abortion-inducing drugs, any act of giving, selling, dispensing,
102	101		administering, transferring possession, or otherwise providing or
103	102		prescribing an abortion-inducing drug.
104	103		SECTION 4. Section 171.063, Health and Safety Code, is
105	104		amended by amending Subsections (a), (c), and (e) and adding
106	105		Subsection (b-1) to read as follows:
107	106		(a) A person may not knowingly [give, sell, dispense,
108	107		administer,] provide[, or prescribe] an abortion-inducing drug to a
109	108		pregnant woman for the purpose of inducing an abortion in the
110	109		pregnant woman or enabling another person to induce an abortion in
111	110		the pregnant woman unless:
112	111		(1) the person who [gives, sells, dispenses,
113	112		administers,] provides[, or prescribes] the abortion-inducing drug
114	113		is a physician; and
115	114		(2) [except as otherwise provided by Subsection (b),]
116	115		the provision[, prescription, or administration] of the
117	116		abortion-inducing drug satisfies the protocol [tested and]
118	117		authorized by this subchapter [the United States Food and Drug
119	118		Administration as outlined in the final printed label of the
120	119		abortion-inducing drug].
121	120		(b-1) A manufacturer, supplier, physician, or any other
122	121		person may not provide to a patient any abortion-inducing drug by
123	122		courier, delivery, or mail service.
124	123		(c) Before the physician [gives, sells, dispenses,
125	124		administers,] provides[, or prescribes] an abortion-inducing drug,
126	125		the physician must:
127	126		(1) examine the pregnant woman in person;
128	127		(2) independently verify that a pregnancy exists;
129	128		(3) [and] document, in the woman's medical record, the
130	129		gestational age and intrauterine location of the pregnancy to
131	130		determine if an ectopic pregnancy exists;
132	131		(4) determine the pregnant woman's blood type, and for
133	132		a woman who is Rh negative, offer to administer Rh immunoglobulin
134	133		(RhoGAM) at the time the abortion is performed or induced to prevent
135	134		Rh incompatibility, complications, or miscarriage in future
136	135		pregnancies;
137	136		(5) document whether the pregnant woman received
138	137		treatment for Rh negativity, as diagnosed by the most accurate
139	138		standard of medical care; and
140	139		(6) ensure the physician does not provide an
141	140		abortion-inducing drug for a pregnant woman whose pregnancy is more
142	141		than 49 days of gestational age.
143	142		(e) A [The] physician who [gives, sells, dispenses,
144	143		administers,] provides[, or prescribes] the abortion-inducing
145	144		drug, or the physician's agent, must schedule a follow-up visit for
146	145		the woman to occur not later [more] than the 14th day [14 days]
147	146		after the earliest date on which the abortion is performed or
148	147		induced or the drug is administered [administration] or used [use
149	148		of the drug]. At the follow-up visit, the physician must:
150	149		(1) confirm that the woman's pregnancy is completely
151	150		terminated; and
152	151		(2) assess any continued blood loss [the degree of
153	152		bleeding].
154	153		SECTION 5. Subchapter D, Chapter 171, Health and Safety
155	154		Code, is amended by adding Sections 171.0631, 171.0632, 171.065,
156	155		and 171.066 to read as follows:
157	156		Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIRED. A
158	157		person may not provide an abortion-inducing drug to a pregnant
159	158		woman without satisfying the applicable informed consent
160	159		requirements of Subchapter B.
161	160		Sec. 171.0632. REPORTING REQUIREMENTS. A physician who
162	161		provides an abortion-inducing drug must comply with the applicable
163	162		physician reporting requirements under Section 245.011.
164	163		Sec. 171.065. CRIMINAL OFFENSE. (a) A person who
165	164		intentionally, knowingly, or recklessly violates this subchapter
166	165		commits an offense. An offense under this subsection is a state
167	166		jail felony.
168	167		(b) A pregnant woman on whom a drug-induced abortion is
169	168		attempted, induced, or performed in violation of this subchapter is
170	169		not criminally liable for the violation.
171	170		(c) Conduct constituting an offense under this section may
172	171		also be the basis for an administrative violation under Section
173	172		171.064.
174	173		Sec. 171.066. ENFORCEMENT OF SUBCHAPTER. A state executive
175	174		or administrative official may not decline to enforce this
176	175		subchapter, or adopt a construction of this subchapter in a way that
177	176		narrows its applicability, based on the official's own beliefs on
178	177		the requirements of the state or federal constitution, unless the
179	178		official is enjoined by a state or federal court from enforcing this
180	179		subchapter.
181	180		SECTION 6. The following provisions of the Health and
182	181		Safety Code are repealed:
183	182		(1) Sections 171.061(3) and (6); and
184	183		(2) Section 171.063(b).
185	184		SECTION 7. (a) Nothing in this Act shall be construed as
186	185		creating or recognizing a right to abortion.
187	186		(b) It is not the intention of this Act to make lawful an
188	187		abortion that is otherwise unlawful.
189	188		(c) Nothing in this Act repeals, replaces, or otherwise
190	189		invalidates existing Texas laws, regulations, or policies.
191	190		SECTION 8. Any provision of this Act held to be invalid or
192	191		unenforceable by its terms or as applied to any person or
193	192		circumstance shall be construed so as to give the provision the
194	193		maximum effect permitted by law, unless such holding is one of utter
195	194		invalidity or unenforceability, in which event the provision shall
196	195		be considered severable from the other provisions of this Act and
197	196		shall not affect the remainder or the application of the provisions
198	197		to other persons not similarly situated or to other, dissimilar
199	198		circumstances.
200	199		SECTION 9. (a) Except as provided by Subsection (b) of this
201	200		section, the changes in law made by this Act apply only to an
202	201		abortion performed or induced on or after the effective date of this
203	202		Act.
204	203		(b) Section 171.065, Health and Safety Code, as added by
205	204		this Act, applies only to an abortion performed or induced on or
206	205		after September 1, 2021.
207	206		SECTION 10. This Act takes effect immediately if it
208	207		receives a vote of two-thirds of all the members elected to each
209	208		house, as provided by Section 39, Article III, Texas Constitution.
210	209		If this Act does not receive the vote necessary for immediate
211	210		effect, this Act takes effect September 1, 2021.