Texas 2021 - 87th 1st C.S.

Texas Senate Bill SB4 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Lucio, et al. S.B. No. 4
	2	+	(In the Senate - Filed July 8, 2021; July 8, 2021, read
	3	+	first time and referred to Committee on Health & Human Services;
	4	+	July 15, 2021, reported adversely, with favorable Committee
	5	+	Substitute by the following vote: Yeas 5, Nays 0; July 15, 2021,
	6	+	sent to printer.)
	7	+	Click here to see the committee vote
	8	+	COMMITTEE SUBSTITUTE FOR S.B. No. 4 By: Perry
2	9
3	10
4	11		A BILL TO BE ENTITLED
5	12		AN ACT
6	13		relating to abortion complication reporting and the regulation of
7	14		drug-induced abortion procedures, providers, and facilities;
8	15		creating a criminal offense.
9	16		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	17		SECTION 1. The legislature finds that:
11	18		(1) this state has an interest in protecting the
12	19		health and welfare of every woman considering a drug-induced
13	20		abortion;
14	21		(2) the use of Mifeprex or mifepristone presents
15	22		significant medical complications including, but not limited to,
16	23		uterine hemorrhage, viral infections, abdominal pain, cramping,
17	24		vomiting, headache, fatigue, and pelvic inflammatory disease; and
18	25		(3) the failure rate and risk of complications
19	26		increases with advancing gestational age.
20	27		SECTION 2. Sections 171.006(a) and (b), Health and Safety
21	28		Code, as added by Chapter 4 (H.B. 13), Acts of the 85th Legislature,
22	29		1st Called Session, 2017, are amended to read as follows:
23	30		(a) In this section, "abortion complication" or "adverse
24	31		event" means any harmful event or adverse outcome with respect to a
25	32		patient related to an abortion that is performed or induced on the
26	33		patient and that is diagnosed or treated by a health care
27	34		practitioner or at a health care facility and includes:
28	35		(1) shock;
29	36		(2) uterine perforation;
30	37		(3) cervical laceration;
31	38		(4) hemorrhage;
32	39		(5) aspiration or allergic response;
33	40		(6) infection;
34	41		(7) sepsis;
35	42		(8) death of the patient;
36	43		(9) incomplete abortion;
37	44		(10) damage to the uterus; [or]
38	45		(11) an infant born alive after the abortion;
39	46		(12) blood clots resulting in pulmonary embolism or
40	47		deep vein thrombosis;
41	48		(13) failure to actually terminate the pregnancy;
42	49		(14) pelvic inflammatory disease;
43	50		(15) endometritis;
44	51		(16) missed ectopic pregnancy;
45	52		(17) cardiac arrest;
46	53		(18) respiratory arrest;
47	54		(19) renal failure;
48	55		(20) metabolic disorder;
49	56		(21) embolism;
50	57		(22) coma;
51	58		(23) placenta previa in subsequent pregnancies;
52	59		(24) preterm delivery in subsequent pregnancies;
53	60		(25) fluid accumulation in the abdomen;
54	61		(26) hemolytic reaction resulting from the
55	62		administration of ABO-incompatible blood or blood products;
56	63		(27) adverse reactions to anesthesia or other drugs;
57	64		or
58	65		(28) any other adverse event as defined by the United
59	66		States Food and Drug Administration's criteria provided by the
60	67		MedWatch Reporting System.
61	68		(b) The reporting requirements of this section apply only
62	69		to:
63	70		(1) a physician who:
64	71		(A) performs or induces at an abortion facility
65	72		an abortion that results in an abortion complication diagnosed or
66	73		treated by that physician; or
67	74		(B) diagnoses or treats [at an abortion facility]
68	75		an abortion complication that is the result of an abortion
69	76		performed or induced by another physician [at the facility]; or
70	77		(2) a health care facility that is a hospital,
71	78		abortion facility, freestanding emergency medical care facility,
72	79		or health care facility that provides emergency medical care, as
73	80		defined by Section 773.003.
74	81		SECTION 3. Section 171.061, Health and Safety Code, is
75	82		amended by amending Subdivisions (2) and (5) and adding
76	83		Subdivisions (2-a) and (8-a) to read as follows:
77	84		(2) "Abortion-inducing drug" means a drug, a medicine,
78	85		or any other substance, including a regimen of two or more drugs,
79	86		medicines, or substances, prescribed, dispensed, or administered
80	87		with the intent of terminating a clinically diagnosable pregnancy
81	88		of a woman and with knowledge that the termination will, with
82	89		reasonable likelihood, cause the death of the woman's unborn child.
83	90		The term includes off-label use of drugs, medicines, or other
84	91		substances known to have abortion-inducing properties that are
85	92		prescribed, dispensed, or administered with the intent of causing
86	93		an abortion, including the Mifeprex regimen, misoprostol
87	94		(Cytotec), and methotrexate. The term does not include a drug,
88	95		medicine, or other substance that may be known to cause an abortion
89	96		but is prescribed, dispensed, or administered for other medical
90	97		reasons.
91	98		(2-a) "Adverse event" or "abortion complication"
92	99		means any harmful event or adverse outcome with respect to a patient
93	100		related to an abortion, including the abortion complications listed
94	101		in Section 171.006, as added by Chapter 4 (H.B. 13), Acts of the
95	102		85th Legislature, 1st Called Session, 2017.
96	103		(5) "Medical abortion" means the administration or use
97	104		of an abortion-inducing drug to induce an abortion, and may also be
98	105		referred to as a "medication abortion," a "chemical abortion," a
99	106		"drug-induced abortion," "RU-486," or the "Mifeprex regimen".
100	107		(8-a) "Provide" means, as used with regard to
101	108		abortion-inducing drugs, any act of giving, selling, dispensing,
102	109		administering, transferring possession, or otherwise providing or
103	110		prescribing an abortion-inducing drug.
104	111		SECTION 4. Section 171.063, Health and Safety Code, is
105	112		amended by amending Subsections (a), (c), and (e) and adding
106	113		Subsection (b-1) to read as follows:
107	114		(a) A person may not knowingly [give, sell, dispense,
108	115		administer,] provide[, or prescribe] an abortion-inducing drug to a
109	116		pregnant woman for the purpose of inducing an abortion in the
110	117		pregnant woman or enabling another person to induce an abortion in
111	118		the pregnant woman unless:
112	119		(1) the person who [gives, sells, dispenses,
113	120		administers,] provides[, or prescribes] the abortion-inducing drug
114	121		is a physician; and
115	122		(2) [except as otherwise provided by Subsection (b),]
116	123		the provision[, prescription, or administration] of the
117	124		abortion-inducing drug satisfies the protocol [tested and]
118	125		authorized by this subchapter [the United States Food and Drug
119	126		Administration as outlined in the final printed label of the
120	127		abortion-inducing drug].
121	128		(b-1) A manufacturer, supplier, physician, or any other
122	129		person may not provide to a patient any abortion-inducing drug by
123	130		courier, delivery, or mail service.
124	131		(c) Before the physician [gives, sells, dispenses,
125	132		administers,] provides[, or prescribes] an abortion-inducing drug,
126	133		the physician must:
127	134		(1) examine the pregnant woman in person;
128	135		(2) independently verify that a pregnancy exists;
129	136		(3) [and] document, in the woman's medical record, the
130	137		gestational age and intrauterine location of the pregnancy to
131	138		determine whether an ectopic pregnancy exists;
132	139		(4) determine the pregnant woman's blood type, and for
133	140		a woman who is Rh negative, offer to administer Rh immunoglobulin
134	141		(RhoGAM) at the time the abortion-inducing drug is administered or
135	142		the abortion is performed or induced to prevent Rh incompatibility,
136	143		complications, or miscarriage in future pregnancies;
137	144		(5) document whether the pregnant woman received
138	145		treatment for Rh negativity, as diagnosed by the most accurate
139	146		standard of medical care; and
140	147		(6) ensure the physician does not provide an
141	148		abortion-inducing drug for a pregnant woman whose pregnancy is more
142	149		than 49 days of gestational age.
143	150		(e) A [The] physician who [gives, sells, dispenses,
144	151		administers,] provides[, or prescribes] the abortion-inducing
145	152		drug, or the physician's agent, must schedule a follow-up visit for
146	153		the woman to occur not later [more] than the 14th day [14 days]
147	154		after the earliest date on which the abortion-inducing drug is
148	155		administered [administration] or used or the abortion is performed
149	156		or induced [use of the drug]. At the follow-up visit, the physician
150	157		must:
151	158		(1) confirm that the woman's pregnancy is completely
152	159		terminated; and
153	160		(2) assess any continued blood loss [the degree of
154	161		bleeding].
155	162		SECTION 5. Subchapter D, Chapter 171, Health and Safety
156	163		Code, is amended by adding Sections 171.0631, 171.0632, 171.065,
157	164		and 171.066 to read as follows:
158	165		Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIRED. A
159	166		person may not provide an abortion-inducing drug to a pregnant
160	167		woman without satisfying the applicable informed consent
161	168		requirements of Subchapter B.
162	169		Sec. 171.0632. REPORTING REQUIREMENTS. A physician who
163	170		provides an abortion-inducing drug must comply with the applicable
164	171		physician reporting requirements under Section 245.011.
165	172		Sec. 171.065. CRIMINAL OFFENSE. (a) A person who
166	173		intentionally, knowingly, or recklessly violates this subchapter
167	174		commits an offense. An offense under this subsection is a state
168	175		jail felony.
169	176		(b) A pregnant woman on whom a drug-induced abortion is
170	177		attempted, induced, or performed in violation of this subchapter is
171	178		not criminally liable for the violation.
172	179		(c) Conduct constituting an offense under this section may
173	180		also be the basis for an administrative violation under Section
174	181		171.064.
175	182		Sec. 171.066. ENFORCEMENT OF SUBCHAPTER. A state executive
176	183		or administrative official may not decline to enforce this
177	184		subchapter, or adopt a construction of this subchapter in a way that
178	185		narrows its applicability, based on the official's own beliefs on
179	186		the requirements of the state or federal constitution, unless the
180	187		official is enjoined by a state or federal court from enforcing this
181	188		subchapter.
182	189		SECTION 6. The following provisions of the Health and
183	190		Safety Code are repealed:
184	191		(1) Sections 171.061(3) and (6); and
185	192		(2) Section 171.063(b).
186	193		SECTION 7. (a) Nothing in this Act shall be construed as
187	194		creating or recognizing a right to abortion.
188	195		(b) It is not the intention of this Act to make lawful an
189	196		abortion that is otherwise unlawful.
190	197		(c) Except as specifically provided by Section 6 of this
191	198		Act, nothing in this Act repeals, replaces, or otherwise
192	199		invalidates existing Texas laws, regulations, or policies.
193	200		SECTION 8. Any provision of this Act held to be invalid or
194	201		unenforceable by its terms or as applied to any person or
195	202		circumstance shall be construed to give the provision the maximum
196	203		effect permitted by law, unless such holding is one of utter
197	204		invalidity or unenforceability, in which event the provision shall
198	205		be considered severable from the other provisions of this Act and
199	206		shall not affect the remainder or the application of the provisions
200	207		to other persons not similarly situated or to other, dissimilar
201	208		circumstances.
202	209		SECTION 9. (a) Except as provided by Subsection (b) of this
203	210		section, the changes in law made by this Act apply only to an
204	211		abortion performed or induced on or after the effective date of this
205	212		Act.
206	213		(b) Section 171.065, Health and Safety Code, as added by
207	214		this Act, applies only to an abortion performed or induced on or
208	215		after December 1, 2021.
209	216		SECTION 10. This Act takes effect immediately if it
210	217		receives a vote of two-thirds of all the members elected to each
211	218		house, as provided by Section 39, Article III, Texas Constitution.
212	219		If this Act does not receive the vote necessary for immediate
213	220		effect, this Act takes effect on the 91st day after the last day of
214	221		the legislative session.
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