Texas 2025 - 89th Regular

Texas House Bill HB44 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Geren H.B. No. 44
	2	+
	3	+
2	4
3	5
4	6		A BILL TO BE ENTITLED
5	7		AN ACT
6	8		relating to exceptions to otherwise prohibited abortions based on a
7	9		physician's reasonable medical judgment.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. This Act may be cited as the Life of the Mother
10	12		Act.
11	13		SECTION 2. Amend Section 74.551, Civil Practice and
12	14		Remedies Code, to read as follows:
13	15		Sec. 74.551. APPLICATION. An action to which Section
14	16		74.552 applies isA civil action brought against a physician or
15	17		health care provider for a violation of a provision of Chapter 170,
16	18		170A, or 171, Health and Safety Code, or Chapter 6-1/2, Title 71,
17	19		Vernon's Texas Civil Statutes, subject to an exception provided by
18	20		the chapter alleged to have been violated or other law, is a health
19	21		care liability claim for purposes of this chapter and is subject to
20	22		the same requirements as any other health care liability claim.
21	23		This section does not affect a health care liability claim based on
22	24		any other ground than a violation of Chapters 170, 170A, or 171,
23	25		Health and Safety Code, or Chapter 6-1/2, Title 71, Vernon's Texas
24	26		Civil Statutes.
25	27		SECTION 3. Section 170A.002(b), Health and Safety Code, is
26	28		amended to read as follows:
27	29		(b) The prohibition underIt is an exception to the
28	30		application of Subsection (a) thatdoes not apply if:
29	31		(1) the person performing, inducing, or attempting the
30	32		abortion is a licensed physician:; and
31	33		(2) in the exercise of reasonable medical judgment,
32	34		the pregnant female on whom the abortion is performed, induced, or
33	35		attempted has a life-threatening physical condition aggravated by,
34	36		caused by, or arising from a pregnancy that places the female at
35	37		risk of death or poses a serious risk of substantial impairment of a
36	38		major bodily function unless the abortion is performed or induced;
37	39		and
38	40		(3) the person performs, induces, or attempts the
39	41		abortion in a manner that, in the exercise of reasonable medical
40	42		judgment, provides the best opportunity for the unborn child to
41	43		survive unless, in the reasonable medical judgment, that manner
42	44		would create:
43	45		(A) a greater risk of the pregnant female's
44	46		death; or
45	47		(B) a serious risk of substantial impairment of a
46	48		major bodily function of the pregnant female.
47	49		SECTION 4. Chapter 170A, Health and Safety Code, is amended
48	50		by adding new Sections 170A.0021, 170A.0022, and 170A.0023 to read
49	51		as follows:
50	52		Sec. 170A.0021. TREATMENT AFFECTING UNBORN CHILD;
51	53		EXCEPTION. (a) Notwithstanding any other law, a physician who
52	54		treats a condition described by Subsection 170A.002(b)(2) shall do
53	55		so in a manner that, in the exercise of reasonable medical judgment,
54	56		provides the best opportunity for survival of an unborn child.
55	57		(b) It is an exception to the application of Subsection (a)
56	58		that, in a physician's reasonable medical judgment, the manner of
57	59		treatment required by that subsection would create a greater risk
58	60		of:
59	61		(1) the pregnant female's death; or
60	62		(2) substantial impairment of a major bodily function
61	63		of the pregnant female.
62	64		(c) This chapter does not require a physician to delay,
63	65		alter or withhold medical treatment provided to a pregnant female
64	66		if doing so would create a greater risk of:
65	67		(1) the pregnant female's death; or
66	68		(2) substantial impairment of a major bodily function
67	69		of the pregnant female.
68	70		(d) Nothing in Subsection (c) authorizes the performance of
69	71		an abortion that is prohibited by law.
70	72		Sec. 170A.0022. REASONABLE MEDICAL JUDGMENT. Reasonable
71	73		medical judgment in providing medical treatment to a pregnant
72	74		female includes removing:
73	75		(1) an ectopic pregnancy as defined by Section
74	76		245.002(4-a); and
75	77		(2) a dead, unborn child whose death was caused by
76	78		spontaneous abortion.
77	79		Sec. 170A.0023. ACCIDENTAL OR UNINTENTIONAL DEATH. (a)
78	80		This section applies to any law that provides an exception to an
79	81		otherwise prohibited abortion based on a condition described by
80	82		Section 170A.002(b)(2).
81	83		(b) It is an exception to the application of each law
82	84		described by Subsection (a) that the death or injury of an unborn
83	85		child resulted from treatment provided to a pregnant female based
84	86		on a physician's reasonable medical judgment if the death of or
85	87		injury to the unborn child was accidental or unintentional.
86	88		SECTION 5. Section 171.002(3), Health and Safety Code, is
87	89		amended to read as follows:
88	90		(3) "Medical emergency" means a condition described by
89	91		Section 170A.002(b)(2)means a life-threatening physical condition
90	92		aggravated by, caused by, or arising from a pregnancy that, as
91	93		certified by a physician, places the woman in danger of death or a
92	94		serious risk of substantial impairment of a major bodily function
93	95		unless an abortion is performed.
94	96		SECTION 6. Section 171.046(a) and (b), Health and Safety
95	97		Code, are amended to read as follows:
96	98		(a) The prohibitions and requirements under Sections
97	99		171.043, 171.044, and 171.045(b) do not apply to an abortion
98	100		performed if there exists a condition that, in the physician's
99	101		reasonable medical judgment, the abortion is necessary due to a
100	102		medical emergency andso complicates the medical condition of the
101	103		woman that, to avert the woman's death or a serious risk of
102	104		substantial and irreversible physical impairment of a major bodily
103	105		function, other than a psychological condition, it necessitates, as
104	106		applicable:
105	107		(1) the immediate abortion of her pregnancy without
106	108		the delay necessary to determine the probable post-fertilization
107	109		age of the unborn child;
108	110		(2) the abortion of her pregnancy even though the
109	111		post-fertilization age of the unborn child is 20 or more weeks; or
110	112		(3) the use of a method of abortion other than a method
111	113		described by Section 171.045(b).
112	114		(b) A physician may not take an action authorized under
113	115		Subsection (a) if the medical emergencyrisk of death or a
114	116		substantial and irreversible physical impairment of a major bodily
115	117		function arises from a claim or diagnosis that the woman will engage
116	118		in conduct that may result in her death or in substantial and
117	119		irreversible physical impairment of a major bodily function.
118	120		SECTION 7. Section 171.063(c), Health and Safety Code, is
119	121		amended to read as follows:
120	122		(c) Before the physician provides an abortion-inducing
121	123		drug, the physician must:
122	124		(1) examine the pregnant woman in person;
123	125		(2) independently verify that a pregnancy exists;
124	126		(3) document, in the woman's medical record, the
125	127		gestational age and intrauterine location of the pregnancy to
126	128		determine whether an ectopic pregnancy exists as defined by Section
127	129		245.002(4-a);
128	130		(4) determine the pregnant woman's blood type, and for
129	131		a woman who is Rh negative, offer to administer Rh immunoglobulin
130	132		(RhoGAM) at the time the abortion-inducing drug is administered or
131	133		used or the abortion is performed or induced to prevent Rh
132	134		incompatibility, complications, or miscarriage in future
133	135		pregnancies;
134	136		(5) document whether the pregnant woman received
135	137		treatment for Rh negativity, as diagnosed by the most accurate
136	138		standard of medical care; and
137	139		(6) ensure the physician does not provide an
138	140		abortion-inducing drug for a pregnant woman whose pregnancy is more
139	141		than 49 days of gestational age.
140	142		SECTION 8. Subchapter H, Chapter 171, Health and Safety
141	143		Code, is amended by adding a new Section 171.2011 to read as
142	144		follows:
143	145		Sec.171.2011. APPLICABILITY. (a) This subchapter applies
144	146		only to an abortion that is otherwise prohibited by law and that is
145	147		not subject to an exception provided by law.
146	148		(b) The following activities do not constitute aiding or
147	149		abetting under this subchapter:
148	150		(1) providing services by a physician or health care
149	151		provider to a treating physician, or communication between a
150	152		physician or health care provider and a treating physician, for the
151	153		purposes of arriving at a reasonable medical judgment as required
152	154		by an exception to an otherwise prohibited abortion;
153	155		(2) communicating between a physician or health care
154	156		provider and a patient, or providing services by a physician or
155	157		health care provider to a patient, for the purpose of arriving at
156	158		reasonable medical judgment as required by an exception to an
157	159		otherwise prohibited abortion;
158	160		(3) communicating between an attorney and a physician
159	161		or health care provider related to an exception to an otherwise
160	162		prohibited abortion;
161	163		(4) communicating between a treating physician and any
162	164		other person or providing services to a treating physician or
163	165		patient relating to performing, inducing or attempting an abortion
164	166		for which the treating physician has determined that, in reasonable
165	167		medical judgment, an exception to an otherwise prohibited abortion
166	168		is applicable;
167	169		(5) providing products to a patient or treating
168	170		physician relating to performing, inducing or attempting an
169	171		abortion for which the treating physician has determined that, in
170	172		reasonable medical judgment, an exception to an otherwise
171	173		prohibited abortion is applicable.
172	174		SECTION 9. Amend Section 245.002(4-a), Health and Safety
173	175		Code, to read as follows:
174	176		(4-a) "Ectopic pregnancy" means the implantation of a
175	177		fertilized egg or embryo:
176	178		(A) outside of the uterus;
177	179		(B) in an abnormal location in the uterus causing
178	180		the fertilized egg or embryo to be non-viable; or
179	181		(C) in a scarred portion of the uterus.
180	182		SECTION 10. Amend Section 245.016, Health and Safety Code,
181	183		to read as follows:
182	184		Sec. 245.016. ABORTION IN UNLICENSED ABORTION FACILITY TO
183	185		PREVENT DEATH OR SERIOUS IMPAIRMENT. It is an exception to the
184	186		application of Section 245.014 that the abortion was performed in
185	187		an unlicensed abortion facility due to a medical emergency
186	188		described by Section 170A.002(b)(2)This chapter does not remove
187	189		the responsibility or limit the ability of a physician to perform an
188	190		abortion in an unlicensed abortion facility if, at the commencement
189	191		of the abortion, the physician reasonably believes that the
190	192		abortion is necessary to prevent the death of the patient or to
191	193		prevent serious impairment of the patient's physical health. In
192	194		this section, the term "unlicensed abortion facility" does not
193	195		include an individual or entity to which funds appropriated by the
194	196		legislature in the general appropriations act are prohibited from
195	197		being distributed.
196	198		SECTION 11. Amend Section 164.052, Occupations Code, by
197	199		adding a new Subsection (d) to read as follows:
198	200		(d) This section may not be construed to prohibit, and the
199	201		board may not take action against a physician regarding, the
200	202		performance of an abortion in response to a medical emergency
201	203		described by Section 170A.002(b)(2), Health and Safety Code.
202	204		SECTION 12. Amend Section 164.055, Occupations Code, by
203	205		adding by amending Subsection (c) to read as follows:
204	206		(c) Notwithstanding Subsection (a), the board may not take
205	207		disciplinary action against a physician who exercised reasonable
206	208		medical judgment in providing medical treatment to a pregnant woman
207	209		as described by Section 74.552, Civil Practice and Remedies Code
208	210		170A.002, Health and Safety Code.
209	211		SECTION 13. Amend Section 165.152, Occupations Code, by
210	212		adding a new Subsection (e) to read as follows:
211	213		(e) It is an exception to the application of Subsection (a)
212	214		if the person is a physician who performs, induces, or attempts an
213	215		abortion due to a medical emergency described by Section
214	216		170A.002(b)(2), Health and Safety Code.
215	217		SECTION 14. Article 4512.6, Chapter 6-1/2, Title 71,
216	218		Vernon's Civil Statutes, is amended to read as follows:
217	219		Art. 4512.6. BYEXCEPTION FOR MEDICAL EMERGENCYADVICE.
218	220		Nothing in this chapter applies to(a) It is an exception to the
219	221		application of this chapter that an abortion is procured, performed
220	222		or attempted due to a medical emergencyby medical advice for the
221	223		purpose of saving the life of the mother.
222	224		(b) In this article, "medical emergency" means a condition
223	225		described by Section 170A.002(b)(2), Health and Safety Code.
224	226		SECTION 15. The exceptions to otherwise prohibited
225	227		abortions described by this Act:
226	228		(1) shall be construed as consistent with the opinion
227	229		of the Texas Supreme Court in In re State, 682 S.W.3d 890 (Tex.
228	230		2023), including with respect to providing that any threat posed by
229	231		a female's pregnancy to her life or major bodily functions need not
230	232		be imminent or irreversible; and
231	233		(2) except as provided by the change in law made by
232	234		this Act to Section 170A.002(b)(2), Health and Safety Code, shall
233	235		be construed as consistent with the opinion of the Texas Supreme
234	236		Court in State v. Zurawski, 690 S.W.3d 644 (Tex. 2024), including
235	237		with respect to the state's burden of proof in any enforcement
236	238		action.
237	239		SECTION 16. The following statutes are repealed:
238	240		(1) Section 74.552, Civil Practice and Remedies Code;
239	241		(2) Section 170A.002(d), Health and Safety Code;
240	242		(3) Section 9.35, Penal Code.
241	243		SECTION 17. (a) To increase the understanding of the legal
242	244		profession regarding the laws regulating abortion following the
243	245		changes in law made by this Act, the State Bar of Texas shall
244	246		develop, or solicit the development of, and offer to attorneys
245	247		licensed in this state a comprehensive program of continuing legal
246	248		education regarding the regulation of abortion in this state, with
247	249		a focus on the exceptions to otherwise prohibited abortions. The
248	250		program shall include legal education regarding:
249	251		(1) statutory terminology applicable to the
250	252		definition and regulation of abortion;
251	253		(2) prohibited abortions and prohibited medical
252	254		techniques related to the performance of abortions;
253	255		(3) state law establishing statutory exceptions to
254	256		otherwise prohibited abortions;
255	257		(4) the civil and criminal implications of abortion
256	258		regulation in this state and the implications of statutory
257	259		exceptions to otherwise prohibited abortions;
258	260		(5) the definition of "medical emergency" as defined
259	261		by Section 170A.002(b)(2), Health and Safety Code;
260	262		(6) the responsibility of a physician to exercise
261	263		reasonable medical judgment in determining whether a condition or
262	264		conditions exist allowing the performance of an abortion during a
263	265		medical emergency; and
264	266		(7) the circumstances under which a physician is
265	267		required under Section 170A.0021, Health and Safety Code, to treat
266	268		a pregnant female who experiences such conditions in a manner that
267	269		maximizes an unborn child's opportunity to survive if doing so does
268	270		not increase the threat to the mother presented by those
269	271		conditions.
270	272		(b) The program required by Subsection (a) shall be:
271	273		(1) developed in cooperation with the Health Law
272	274		Section of the State Bar of Texas, physician and health care
273	275		provider organizations, and other non-State Bar of Texas
274	276		stakeholders with a demonstrated interest and expertise in the
275	277		required subject matter; and
276	278		(2) be promoted by communications made by the State
277	279		Bar to all attorneys in this state, organizations representing
278	280		physicians and health care providers whose members treat pregnant
279	281		women, and health care institutions as defined by Section 74.001,
280	282		Civil Practice and Remedies Codes.
281	283		(c) The course of instruction required by Subsection (a)
282	284		must be offered at no cost to attorneys licensed in this state and
283	285		shall be offered on the Internet provided through the state bar in
284	286		addition to any other method approved by the state bar.
285	287		(d) The program required by Subsection (a) shall be offered
286	288		no later than January 1, 2026.
287	289		SECTION 18. (a)(1) No later than January 1, 2026, the Texas
288	290		Medical Board shall make available one or more approved courses
289	291		regarding the laws relating to pregnancy-related medical
290	292		emergencies as the term "medical emergency" is used in Title 2,
291	293		Subtitle H, Health and Safety Code.
292	294		(2) The board may solicit the development of a course
293	295		required by Subsection (1) by organizations representing
294	296		physicians, institutions of higher education with medical schools,
295	297		or other providers of continuing education to physicians acceptable
296	298		to the board.
297	299		(3) After approval of a continuing education course
298	300		required by this subsection, the board shall inform all licensed
299	301		physicians in this state of the availability of the course and
300	302		request organizations representing physicians in general and
301	303		physicians who practice in specialties that treat pregnant women to
302	304		make the availability of the course known to their members.
303	305		(b) Completion of a course described by Subsection (a) shall
304	306		be credited to the requirements for continuing medical education
305	307		enforced by the Texas Medical Board.
306	308		(c) A course approved under Subsection (a) shall address:
307	309		(1) what does and does not constitute an abortion,
308	310		including exclusions from that term for ectopic pregnancy and
309	311		spontaneous abortion;
310	312		(2) the laws prohibiting abortion and any procedures
311	313		prohibited by law for performing an abortion;
312	314		(3) the statutory exceptions to laws prohibiting
313	315		abortion with an emphasis on exceptions based on a medical
314	316		emergency as the term "medical emergency" is used in Title 2,
315	317		Subtitle H, Health and Safety Code; and
316	318		(4) the laws regarding reasonable medical judgment as
317	319		used in connection with the medical emergency exceptions to laws
318	320		prohibiting abortions.
319	321		(d) Continuing medical education described in whole or in
320	322		part by Subsection (c) does not constitute aiding or abetting as
321	323		those terms are used in Subchapter H, Chapter 171, Health and Safety
322	324		Code.
323	325		(e)(1) A physician licensed to practice medicine under
324	326		Subtitle B, Title 3, Occupations Code, who provides obstetric care
325	327		shall complete no later than June 1, 2027, a course described by
326	328		Subsection (a) that equals at least one hour of continuing medical
327	329		education. This is a one-time requirement.
328	330		(2) The license of a physician described by Subsection
329	331		(1) shall not be renewed if the physician has not complied with that
330	332		subsection.
331	333		(3) The Texas Medical Board shall adopt rules to
332	334		implement this subsection.
333	335		(f) The board shall make available at least one course
334	336		required by this section at no cost to physicians licensed in this
335	337		state and include on its internet website a list of courses of
336	338		continuing medical education approved under Subsection (a).
337	339		(g) Nothing in Subsections (a) through (f):
338	340		(1) creates a cause of action or a standard of care,
339	341		obligation or duty that provides the basis for a cause of action; or
340	342		(2) affects a health care liability claim, as defined
341	343		by Section 74.001(13), Civil Practice and Remedies Code, based on
342	344		any ground other than a violation of Chapters 170, 170A, or 171,
343	345		Health and Safety Code, or Chapter 6-1/2, Title 71, Vernon's Texas
344	346		Civil Statutes.
345	347		SECTION 19. This Act takes effect immediately if it
346	348		receives a vote of two-thirds of all the members elected to each
347	349		house, as provided by Section 39, Article III, Texas Constitution.
348	350		If this Act does not receive the vote necessary for immediate
349	351		effect, this Act takes effect September 1, 2025.