Texas 2021 - 87th 2nd C.S.

Texas Senate Bill SB4 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 4
	1	+	By: Lucio, et al. S.B. No. 4
	2	+	(Klick, Noble, Oliverson, Cook, Frank, et al.)
2	3
3	4
	5	+	A BILL TO BE ENTITLED
4	6		AN ACT
5	7		relating to abortion complication reporting and the regulation of
6	8		drug-induced abortion procedures, providers, and facilities;
7	9		creating a criminal offense.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. The legislature finds that:
10	12		(1) this state has an interest in protecting the
11	13		health and welfare of every woman considering a drug-induced
12	14		abortion;
13	15		(2) the use of Mifeprex or mifepristone presents
14	16		significant medical complications including, but not limited to,
15	17		uterine hemorrhage, viral infections, abdominal pain, cramping,
16	18		vomiting, headache, fatigue, and pelvic inflammatory disease; and
17	19		(3) the failure rate and risk of complications
18	20		increases with advancing gestational age.
19	21		SECTION 2. Sections 171.006(a) and (b), Health and Safety
20	22		Code, as added by Chapter 4 (H.B. 13), Acts of the 85th Legislature,
21	23		1st Called Session, 2017, are amended to read as follows:
22	24		(a) In this section, "abortion complication" or "adverse
23	25		event" means any harmful event or adverse outcome with respect to a
24	26		patient related to an abortion that is performed or induced on the
25	27		patient and that is diagnosed or treated by a health care
26	28		practitioner or at a health care facility and includes:
27	29		(1) shock;
28	30		(2) uterine perforation;
29	31		(3) cervical laceration;
30	32		(4) hemorrhage;
31	33		(5) aspiration or allergic response;
32	34		(6) infection;
33	35		(7) sepsis;
34	36		(8) death of the patient;
35	37		(9) incomplete abortion;
36	38		(10) damage to the uterus; [or]
37	39		(11) an infant born alive after the abortion;
38	40		(12) blood clots resulting in pulmonary embolism or
39	41		deep vein thrombosis;
40	42		(13) failure to actually terminate the pregnancy;
41	43		(14) pelvic inflammatory disease;
42	44		(15) endometritis;
43	45		(16) missed ectopic pregnancy;
44	46		(17) cardiac arrest;
45	47		(18) respiratory arrest;
46	48		(19) renal failure;
47	49		(20) metabolic disorder;
48	50		(21) embolism;
49	51		(22) coma;
50	52		(23) placenta previa in subsequent pregnancies;
51	53		(24) preterm delivery in subsequent pregnancies;
52	54		(25) fluid accumulation in the abdomen;
53	55		(26) hemolytic reaction resulting from the
54	56		administration of ABO-incompatible blood or blood products;
55	57		(27) adverse reactions to anesthesia or other drugs;
56	58		or
57	59		(28) any other adverse event as defined by the United
58	60		States Food and Drug Administration's criteria provided by the
59	61		MedWatch Reporting System.
60	62		(b) The reporting requirements of this section apply only
61	63		to:
62	64		(1) a physician who:
63	65		(A) performs or induces at an abortion facility
64	66		an abortion that results in an abortion complication diagnosed or
65	67		treated by that physician; or
66	68		(B) diagnoses or treats [at an abortion facility]
67	69		an abortion complication that is the result of an abortion
68	70		performed or induced by another physician [at the facility]; or
69	71		(2) a health care facility that is a hospital,
70	72		abortion facility, freestanding emergency medical care facility,
71	73		or health care facility that provides emergency medical care, as
72	74		defined by Section 773.003.
73	75		SECTION 3. Section 171.061, Health and Safety Code, is
74	76		amended by amending Subdivisions (2) and (5) and adding
75	77		Subdivisions (2-a) and (8-a) to read as follows:
76	78		(2) "Abortion-inducing drug" means a drug, a medicine,
77	79		or any other substance, including a regimen of two or more drugs,
78	80		medicines, or substances, prescribed, dispensed, or administered
79	81		with the intent of terminating a clinically diagnosable pregnancy
80	82		of a woman and with knowledge that the termination will, with
81	83		reasonable likelihood, cause the death of the woman's unborn child.
82	84		The term includes off-label use of drugs, medicines, or other
83	85		substances known to have abortion-inducing properties that are
84	86		prescribed, dispensed, or administered with the intent of causing
85	87		an abortion, including the Mifeprex regimen, misoprostol
86	88		(Cytotec), and methotrexate. The term does not include a drug,
87	89		medicine, or other substance that may be known to cause an abortion
88	90		but is prescribed, dispensed, or administered for other medical
89	91		reasons.
90	92		(2-a) "Adverse event" or "abortion complication"
91	93		means any harmful event or adverse outcome with respect to a patient
92	94		related to an abortion, including the abortion complications listed
93	95		in Section 171.006, as added by Chapter 4 (H.B. 13), Acts of the
94	96		85th Legislature, 1st Called Session, 2017.
95	97		(5) "Medical abortion" means the administration or use
96	98		of an abortion-inducing drug to induce an abortion, and may also be
97	99		referred to as a "medication abortion," a "chemical abortion," a
98	100		"drug-induced abortion," "RU-486," or the "Mifeprex regimen".
99	101		(8-a) "Provide" means, as used with regard to
100	102		abortion-inducing drugs, any act of giving, selling, dispensing,
101	103		administering, transferring possession, or otherwise providing or
102	104		prescribing an abortion-inducing drug.
103	105		SECTION 4. The heading to Section 171.063, Health and
104	106		Safety Code, is amended to read as follows:
105	107		Sec. 171.063. PROVISION [DISTRIBUTION] OF
106	108		ABORTION-INDUCING DRUG.
107	109		SECTION 5. Section 171.063, Health and Safety Code, is
108	110		amended by amending Subsections (a), (c), and (e) and adding
109	111		Subsection (b-1) to read as follows:
110	112		(a) A person may not knowingly [give, sell, dispense,
111	113		administer,] provide[, or prescribe] an abortion-inducing drug to a
112	114		pregnant woman for the purpose of inducing an abortion in the
113	115		pregnant woman or enabling another person to induce an abortion in
114	116		the pregnant woman unless:
115	117		(1) the person who [gives, sells, dispenses,
116	118		administers,] provides[, or prescribes] the abortion-inducing drug
117	119		is a physician; and
118	120		(2) [except as otherwise provided by Subsection (b),]
119	121		the provision[, prescription, or administration] of the
120	122		abortion-inducing drug satisfies the protocol [tested and]
121	123		authorized by this subchapter [the United States Food and Drug
122	124		Administration as outlined in the final printed label of the
123	125		abortion-inducing drug].
124	126		(b-1) A manufacturer, supplier, physician, or any other
125	127		person may not provide to a patient any abortion-inducing drug by
126	128		courier, delivery, or mail service.
127	129		(c) Before the physician [gives, sells, dispenses,
128	130		administers,] provides[, or prescribes] an abortion-inducing drug,
129	131		the physician must:
130	132		(1) examine the pregnant woman in person;
131	133		(2) independently verify that a pregnancy exists;
132	134		(3) [and] document, in the woman's medical record, the
133	135		gestational age and intrauterine location of the pregnancy to
134	136		determine whether an ectopic pregnancy exists;
135	137		(4) determine the pregnant woman's blood type, and for
136	138		a woman who is Rh negative, offer to administer Rh immunoglobulin
137	139		(RhoGAM) at the time the abortion-inducing drug is administered or
138	140		used or the abortion is performed or induced to prevent Rh
139	141		incompatibility, complications, or miscarriage in future
140	142		pregnancies;
141	143		(5) document whether the pregnant woman received
142	144		treatment for Rh negativity, as diagnosed by the most accurate
143	145		standard of medical care; and
144	146		(6) ensure the physician does not provide an
145	147		abortion-inducing drug for a pregnant woman whose pregnancy is more
146	148		than 49 days of gestational age.
147	149		(e) A [The] physician who [gives, sells, dispenses,
148	150		administers,] provides[, or prescribes] the abortion-inducing
149	151		drug, or the physician's agent, must schedule a follow-up visit for
150	152		the woman to occur not later [more] than the 14th day [14 days]
151	153		after the earliest date on which the abortion-inducing drug is
152	154		administered [administration] or used or the abortion is performed
153	155		or induced [use of the drug]. At the follow-up visit, the physician
154	156		must:
155	157		(1) confirm that the woman's pregnancy is completely
156	158		terminated; and
157	159		(2) assess any continued blood loss [the degree of
158	160		bleeding].
159	161		SECTION 6. Subchapter D, Chapter 171, Health and Safety
160	162		Code, is amended by adding Sections 171.0631, 171.0632, 171.065,
161	163		and 171.066 to read as follows:
162	164		Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIRED. A
163	165		person may not provide an abortion-inducing drug to a pregnant
164	166		woman without satisfying the applicable informed consent
165	167		requirements of Subchapter B.
166	168		Sec. 171.0632. REPORTING REQUIREMENTS. A physician who
167	169		provides an abortion-inducing drug must comply with the applicable
168	170		physician reporting requirements under Section 245.011.
169	171		Sec. 171.065. CRIMINAL OFFENSE. (a) A person who
170	172		intentionally, knowingly, or recklessly violates this subchapter
171	173		commits an offense. An offense under this subsection is a state
172	174		jail felony.
173	175		(b) A pregnant woman on whom a drug-induced abortion is
174	176		attempted, induced, or performed in violation of this subchapter is
175	177		not criminally liable for the violation.
176	178		(c) Conduct constituting an offense under this section may
177	179		also be the basis for an administrative violation under Section
178	180		171.064.
179	181		Sec. 171.066. ENFORCEMENT OF SUBCHAPTER. A state executive
180	182		or administrative official may not decline to enforce this
181	183		subchapter, or adopt a construction of this subchapter in a way that
182	184		narrows its applicability, based on the official's own beliefs on
183	185		the requirements of the state or federal constitution, unless the
184	186		official is enjoined by a state or federal court from enforcing this
185	187		subchapter.
186	188		SECTION 7. The following provisions of the Health and
187	189		Safety Code are repealed:
188	190		(1) Sections 171.061(3) and (6); and
189	191		(2) Section 171.063(b).
190	192		SECTION 8. (a) Nothing in this Act shall be construed as
191	193		creating or recognizing a right to abortion.
192	194		(b) It is not the intention of this Act to make lawful an
193	195		abortion that is otherwise unlawful.
194	196		(c) Except as specifically provided by Section 7 of this
195	197		Act, nothing in this Act repeals, replaces, or otherwise
196	198		invalidates existing Texas laws, regulations, or policies.
197	199		SECTION 9. Any provision of this Act held to be invalid or
198	200		unenforceable by its terms or as applied to any person or
199	201		circumstance shall be construed to give the provision the maximum
200	202		effect permitted by law, unless such holding is one of utter
201	203		invalidity or unenforceability, in which event the provision shall
202	204		be considered severable from the other provisions of this Act and
203	205		shall not affect the remainder or the application of the provisions
204	206		to other persons not similarly situated or to other, dissimilar
205	207		circumstances.
206	208		SECTION 10. (a) Except as provided by Subsection (b) of
207	209		this section, the changes in law made by this Act apply only to an
208	210		abortion performed or induced on or after the effective date of this
209	211		Act.
210	212		(b) Section 171.065, Health and Safety Code, as added by
211	213		this Act, applies only to an abortion performed or induced on or
212	214		after January 1, 2022.
213	215		SECTION 11. This Act takes effect immediately if it
214	216		receives a vote of two-thirds of all the members elected to each
215	217		house, as provided by Section 39, Article III, Texas Constitution.
216	218		If this Act does not receive the vote necessary for immediate
217	219		effect, this Act takes effect on the 91st day after the last day of
218	220		the legislative session.
219		-	______________________________ ______________________________
220		-	President of the Senate Speaker of the House
221		-	I hereby certify that S.B. No. 4 passed the Senate on
222		-	August 11, 2021, by the following vote: Yeas 19, Nays 10.
223		-	______________________________
224		-	Secretary of the Senate
225		-	I hereby certify that S.B. No. 4 passed the House on
226		-	August 31, 2021, by the following vote: Yeas 82, Nays 41, one
227		-	present not voting.
228		-	______________________________
229		-	Chief Clerk of the House
230		-	Approved:
231		-	______________________________
232		-	Date
233		-	______________________________
234		-	Governor