Texas 2025 - 89th Regular

Texas Senate Bill SB2768 Compare Versions

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1	1	By: Cook, Eckhardt S.B. No. 2768
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6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to certain health care services, increasing access to
9	9	health care, and repealing or replacing medically unnecessary and
10	10	outdated health care restrictions.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	ARTICLE 1. GENERAL PROVISIONS
13	13	SECTION 1.01. This Act may be cited as the Health Freedom
14	14	for Texans Act.
15	15	SECTION 1.02. The legislature finds that:
16	16	(1) comprehensive reproductive health care, including
17	17	safe abortion care and health care services for transgender and
18	18	gender-nonconforming persons, is a vital component of a person's
19	19	overall health and of their social and economic equality;
20	20	(2) abortion is one of the safest medical procedures
21	21	in the United States, as demonstrated by available data, including
22	22	from the Centers for Disease Control and Prevention, showing
23	23	abortion has a more than 99 percent safety record;
24	24	(3) any regulation of medical care must have a
25	25	legitimate and verifiable purpose and advance the goals of
26	26	improving the quality of care and increasing access to care;
27	27	(4) according to the American College of Obstetricians
28	28	and Gynecologists, American Medical Association, American Academy
29	29	of Family Physicians, and American Osteopathic Association,
30	30	"access to high-quality, evidence-based abortion care should not be
31	31	limited by laws enacted under the guise of patient safety but that,
32	32	in fact, [cause] harm"; and
33	33	(5) the almost complete abortion ban and the onerous
34	34	restrictions enacted in this state based on pretextual reasons are
35	35	a systematic attempt to eliminate access to safe and necessary
36	36	medical care.
37	37	ARTICLE 2. INCREASING ACCESS TO HEALTH CARE
38	38	SECTION 2.01. Section 32.003, Family Code, is amended by
39	39	amending Subsection (a) and adding Subsection (g) to read as
40	40	follows:
41	41	(a) A child may consent to medical, dental, psychological,
42	42	and surgical treatment for the child by a licensed physician or
43	43	dentist if the child:
44	44	(1) is on active duty with the armed services of the
45	45	United States of America;
46	46	(2) is:
47	47	(A) 16 years of age or older and resides separate
48	48	and apart from the child's parents, managing conservator, or
49	49	guardian, with or without the consent of the parents, managing
50	50	conservator, or guardian and regardless of the duration of the
51	51	residence; and
52	52	(B) managing the child's own financial affairs,
53	53	regardless of the source of the income;
54	54	(3) consents to the diagnosis and treatment of an
55	55	infectious, contagious, or communicable disease that is required by
56	56	law or a rule to be reported by the licensed physician or dentist to
57	57	a local health officer or the [Texas] Department of State Health
58	58	Services, including all diseases within the scope of Section
59	59	81.041, Health and Safety Code;
60	60	(4) is unmarried and pregnant and consents to
61	61	hospital, medical, or surgical treatment[, other than abortion,]
62	62	related to the pregnancy;
63	63	(5) consents to examination and treatment for drug or
64	64	chemical addiction, drug or chemical dependency, or any other
65	65	condition directly related to drug or chemical use;
66	66	(6) is unmarried, is the parent of a child, and has
67	67	actual custody of the [his or her] child and consents to medical,
68	68	dental, psychological, or surgical treatment for the child; [or]
69	69	(7) is serving a term of confinement in a facility
70	70	operated by or under contract with the Texas Department of Criminal
71	71	Justice; or
72	72	(8) consents to a contraception-related examination
73	73	or medical treatment[, unless the treatment would constitute a
74	74	prohibited practice under Section 164.052(a)(19), Occupations
75	75	Code].
76	76	(g) In this section, "contraception" means any reversible
77	77	method of preventing pregnancy that is approved by the United
78	78	States Food and Drug Administration.
79	79	SECTION 2.02. Section 501.065, Government Code, is amended
80	80	to read as follows:
81	81	Sec. 501.065. CONSENT TO MEDICAL, DENTAL, PSYCHOLOGICAL,
82	82	AND SURGICAL TREATMENT. An inmate who is younger than 18 years of
83	83	age and is confined in a facility operated by or under contract with
84	84	the department may, in accordance with procedures established by
85	85	the department, consent to medical, dental, psychological, and
86	86	surgical treatment for the inmate by a licensed health care
87	87	practitioner, or a person under the direction of a licensed health
88	88	care practitioner[, unless the treatment would constitute a
89	89	prohibited practice under Section 164.052(a)(19), Occupations
90	90	Code].
91	91	SECTION 2.03. Section 62.151, Health and Safety Code, is
92	92	amended by amending Subsection (c) and adding Subsections (h) and
93	93	(i) to read as follows:
94	94	(c) In modifying the plan, the executive commissioner shall
95	95	ensure that primary and preventive health benefits [do not] include
96	96	reproductive services, such as contraception, abortion services,
97	97	[other than] prenatal care, and care related to diseases,
98	98	illnesses, or abnormalities related to the reproductive system.
99	99	(h) Subject to Subsection (i), the child health plan must
100	100	provide as covered benefits prescription contraceptive drugs or
101	101	devices approved by the United States Food and Drug Administration.
102	102	(i) The child health plan shall provide as covered benefits
103	103	prescription contraceptive drugs or devices for an enrolled child
104	104	17 years of age or younger for the purpose of primary and preventive
105	105	reproductive health care if the prescribing health care provider
106	106	receives written consent for the prescription from:
107	107	(1) the enrolled child's parent, guardian, or managing
108	108	conservator; or
109	109	(2) the enrolled child or other adult if authorized
110	110	under Section 32.001 or 32.003, Family Code, for the prescription
111	111	or dispensing of the contraceptive drug or device.
112	112	SECTION 2.04. Section 171.002(1), Health and Safety Code,
113	113	is amended to read as follows:
114	114	(1) "Abortion" means an act or procedure performed
115	115	after pregnancy has been medically verified and with the intent to
116	116	cause the termination of a pregnancy other than for the purpose of
117	117	either the birth of a live fetus or the removal of a dead fetus. The
118	118	term does not include birth control devices or oral contraceptives
119	119	[has the meaning assigned by Section 245.002].
120	120	SECTION 2.05. Subtitle H, Title 2, Health and Safety Code,
121	121	is amended by adding Chapter 174 to read as follows:
122	122	CHAPTER 174. REPRODUCTIVE AUTONOMY
123	123	Sec. 174.001. INTERNET WEBSITE ON REPRODUCTIVE RIGHTS AND
124	124	RELATED RESOURCES. (a) The commission shall develop and maintain a
125	125	web page on the commission's Internet website with information on
126	126	the rights of an individual in this state to:
127	127	(1) obtain an abortion or related health care services
128	128	in this state;
129	129	(2) receive treatment for a miscarriage or an ectopic
130	130	pregnancy;
131	131	(3) access telemedicine medical services or
132	132	telehealth services for an abortion; and
133	133	(4) self-manage an abortion.
134	134	(b) The information required under Subsection (a) must be
135	135	printed in each of the five most spoken languages in this state.
136	136	SECTION 2.06. Section 32.024, Human Resources Code, is
137	137	amended by amending Subsections (e) and (l-1) to read as follows:
138	138	(e) Except as provided by Section 32.03118, the [The]
139	139	commission may not authorize the provision of any service to any
140	140	person under the program unless federal matching funds are
141	141	available to pay the cost of the service.
142	142	(l-1) The commission shall continue to provide medical
143	143	assistance to an individual [a woman] who is eligible for medical
144	144	assistance for pregnant individuals [women] for a period of not
145	145	less than 24[:
146	146	[(1) six months following the date the woman delivers
147	147	or experiences an involuntary miscarriage; and
148	148	[(2) 12] months that begins on the last day of the
149	149	individual's [woman's] pregnancy and ends on the last day of the
150	150	month in which the 24-month [12-month] period ends [in accordance
151	151	with Section 1902(e)(16), Social Security Act (42 U.S.C. Section
152	152	1396a(e)(16))].
153	153	SECTION 2.07. Subchapter B, Chapter 32, Human Resources
154	154	Code, is amended by adding Section 32.03118 to read as follows:
155	155	Sec. 32.03118. REIMBURSEMENT FOR CERTAIN REPRODUCTIVE
156	156	HEALTH SERVICES. (a) Regardless of whether federal matching funds
157	157	are available to pay the cost of the services, the commission shall
158	158	ensure that medical assistance reimbursement is provided for the
159	159	provision of the following services to medical assistance
160	160	recipients:
161	161	(1) abortion services;
162	162	(2) forms of contraception approved by the United
163	163	States Food and Drug Administration, including the insertion and
164	164	removal of devices; and
165	165	(3) voluntary sterilization, including vasectomies.
166	166	(b) The commission shall ensure that abortion,
167	167	contraception, and sterilization services are provided in
168	168	accordance with applicable state and federal law.
169	169	(c) Notwithstanding any other law, abortion, contraception,
170	170	and sterilization services provided under the medical assistance
171	171	program may not be subject to:
172	172	(1) a cost-sharing requirement, including a
173	173	deductible or coinsurance;
174	174	(2) utilization review;
175	175	(3) a prior authorization or step-therapy
176	176	requirement; or
177	177	(4) any restrictions on or delays in coverage.
178	178	SECTION 2.08. Chapter 32, Human Resources Code, is amended
179	179	by adding Subchapter H to read as follows:
180	180	SUBCHAPTER H. EXPANSION OF ELIGIBILITY FOR MEDICAL ASSISTANCE
181	181	Sec. 32.351. EXPANDED ELIGIBILITY FOR MEDICAL ASSISTANCE
182	182	UNDER PATIENT PROTECTION AND AFFORDABLE CARE ACT. (a)
183	183	Notwithstanding any other law, the commission shall provide medical
184	184	assistance to all individuals who apply for that assistance and for
185	185	whom federal matching funds are available under the Patient
186	186	Protection and Affordable Care Act (Pub. L. No. 111-148), as
187	187	amended by the Health Care and Education Reconciliation Act of 2010
188	188	(Pub. L. No. 111-152), to provide that assistance.
189	189	(b) The executive commissioner shall adopt rules regarding
190	190	the provision of medical assistance as required by this section.
191	191	Sec. 32.352. ANNUAL REPORT ON EXPANDED ELIGIBILITY FOR
192	192	MEDICAL ASSISTANCE. Not later than December 1 of each year, the
193	193	commission shall report to the governor, the lieutenant governor,
194	194	the speaker of the house of representatives, and the standing
195	195	committees of the senate and the house of representatives having
196	196	primary jurisdiction over the medical assistance program on the
197	197	effects of expanding eligibility for medical assistance under
198	198	Section 32.351, including the effects on:
199	199	(1) the number of individuals in this state who do not
200	200	have health benefits coverage;
201	201	(2) state health care costs, including costs relating
202	202	to programs funded with money appropriated out of the general
203	203	revenue fund;
204	204	(3) local health care costs; and
205	205	(4) charity care and uncompensated care costs for
206	206	hospitals.
207	207	SECTION 2.09. The heading to Chapter 1218, Insurance Code,
208	208	is amended to read as follows:
209	209	CHAPTER 1218. COVERAGE FOR REPRODUCTIVE HEALTH SERVICES
210	210	[ELECTIVE ABORTION; PROHIBITIONS AND REQUIREMENTS]
211	211	SECTION 2.10. Sections 1218.001 and 1218.004, Insurance
212	212	Code, are amended to read as follows:
213	213	Sec. 1218.001. DEFINITIONS [DEFINITION]. In this chapter:
214	214	(1) "Abortion" has the meaning assigned[, "elective
215	215	abortion" means an abortion, as defined] by Section [245.002,
216	216	Health and Safety Code, other than an abortion performed due to a
217	217	medical emergency as defined by Section] 171.002, Health and Safety
218	218	Code.
219	219	(2) "Effective pain and anxiety management" means
220	220	evidence-based pain and anxiety management, including prescription
221	221	antianxiety medication, local anesthesia, topical anesthetic,
222	222	paracervical block, and minimal and moderate sedation.
223	223	Sec. 1218.004. COVERAGE REQUIRED [BY HEALTH BENEFIT
224	224	PLAN]. (a) A health benefit plan shall [may] provide coverage for
225	225	abortion services, all forms of contraception approved by the
226	226	United States Food and Drug Administration including the insertion
227	227	and removal of devices and counseling on and provision of effective
228	228	pain and anxiety management for the insertion or removal of
229	229	devices, and voluntary sterilization including vasectomies, in
230	230	accordance with applicable state and federal law.
231	231	(b) Coverage required under this section is not subject to
232	232	[elective abortion only if]:
233	233	(1) a cost-sharing requirement, including a
234	234	deductible or coinsurance [the coverage is provided to an enrollee
235	235	separately from other health benefit plan coverage offered by the
236	236	health benefit plan issuer];
237	237	(2) utilization review [the enrollee pays the premium
238	238	for coverage for elective abortion separately from, and in addition
239	239	to, the premium for other health benefit plan coverage, if any];
240	240	[and]
241	241	(3) a prior authorization or step-therapy requirement;
242	242	or
243	243	(4) any restrictions on or delays in coverage [the
244	244	enrollee provides a signature for coverage for elective abortion,
245	245	separately and distinct from the signature required for other
246	246	health benefit plan coverage, if any, provided to the enrollee by
247	247	the health benefit plan issuer].
248	248	(c) This section controls over Subchapter C, Chapter 1369,
249	249	to the extent of any conflict.
250	250	SECTION 2.11. Section 1369.1031(c), Insurance Code, is
251	251	amended to read as follows:
252	252	(c) A health benefit plan that provides benefits for a
253	253	prescription contraceptive drug must provide for an enrollee to
254	254	obtain up to[:
255	255	[(1) a three-month supply of the covered prescription
256	256	contraceptive drug at one time the first time the enrollee obtains
257	257	the drug; and
258	258	[(2)] a 12-month supply of the covered prescription
259	259	contraceptive drug at one time each [subsequent] time the enrollee
260	260	obtains the [same] drug, regardless of whether the enrollee was
261	261	enrolled in the health benefit plan the first time the enrollee
262	262	obtained the drug.
263	263	SECTION 2.12. Section 164.052(a), Occupations Code, is
264	264	amended to read as follows:
265	265	(a) A physician or an applicant for a license to practice
266	266	medicine commits a prohibited practice if that person:
267	267	(1) submits to the board a false or misleading
268	268	statement, document, or certificate in an application for a
269	269	license;
270	270	(2) presents to the board a license, certificate, or
271	271	diploma that was illegally or fraudulently obtained;
272	272	(3) commits fraud or deception in taking or passing an
273	273	examination;
274	274	(4) uses alcohol or drugs in an intemperate manner
275	275	that, in the board's opinion, could endanger a patient's life;
276	276	(5) commits unprofessional or dishonorable conduct
277	277	that is likely to deceive or defraud the public, as provided by
278	278	Section 164.053, or injure the public;
279	279	(6) uses an advertising statement that is false,
280	280	misleading, or deceptive;
281	281	(7) advertises professional superiority or the
282	282	performance of professional service in a superior manner if that
283	283	advertising is not readily subject to verification;
284	284	(8) purchases, sells, barters, or uses, or offers to
285	285	purchase, sell, barter, or use, a medical degree, license,
286	286	certificate, or diploma, or a transcript of a license, certificate,
287	287	or diploma in or incident to an application to the board for a
288	288	license to practice medicine;
289	289	(9) alters, with fraudulent intent, a medical license,
290	290	certificate, or diploma, or a transcript of a medical license,
291	291	certificate, or diploma;
292	292	(10) uses a medical license, certificate, or diploma,
293	293	or a transcript of a medical license, certificate, or diploma that
294	294	has been:
295	295	(A) fraudulently purchased or issued;
296	296	(B) counterfeited; or
297	297	(C) materially altered;
298	298	(11) impersonates or acts as proxy for another person
299	299	in an examination required by this subtitle for a medical license;
300	300	(12) engages in conduct that subverts or attempts to
301	301	subvert an examination process required by this subtitle for a
302	302	medical license;
303	303	(13) impersonates a physician or permits another to
304	304	use the person's license or certificate to practice medicine in
305	305	this state;
306	306	(14) directly or indirectly employs a person whose
307	307	license to practice medicine has been suspended, canceled, or
308	308	revoked;
309	309	(15) associates in the practice of medicine with a
310	310	person:
311	311	(A) whose license to practice medicine has been
312	312	suspended, canceled, or revoked; or
313	313	(B) who has been convicted of the unlawful
314	314	practice of medicine in this state or elsewhere;
315	315	(16) [performs or procures a criminal abortion, aids
316	316	or abets in the procuring of a criminal abortion, attempts to
317	317	perform or procure a criminal abortion, or attempts to aid or abet
318	318	the performance or procurement of a criminal abortion;
319	319	[(17)] directly or indirectly aids or abets the
320	320	practice of medicine by a person, partnership, association, or
321	321	corporation that is not licensed to practice medicine by the board;
322	322	(17) [(18) performs an abortion on a woman who is
323	323	pregnant with a viable unborn child during the third trimester of
324	324	the pregnancy unless:
325	325	[(A) the abortion is necessary to prevent the
326	326	death of the woman;
327	327	[(B) the viable unborn child has a severe,
328	328	irreversible brain impairment; or
329	329	[(C) the woman is diagnosed with a significant
330	330	likelihood of suffering imminent severe, irreversible brain damage
331	331	or imminent severe, irreversible paralysis;
332	332	[(19) performs an abortion on an unemancipated minor
333	333	without the written consent of the child's parent, managing
334	334	conservator, or legal guardian or without a court order, as
335	335	provided by Section 33.003 or 33.004, Family Code, unless the
336	336	abortion is necessary due to a medical emergency, as defined by
337	337	Section 171.002, Health and Safety Code;
338	338	[(20) otherwise performs an abortion on an
339	339	unemancipated minor in violation of Chapter 33, Family Code;
340	340	[(21) performs or induces or attempts to perform or
341	341	induce an abortion in violation of Subchapter C, F, or G, Chapter
342	342	171, Health and Safety Code;
343	343	[(22)] in complying with the procedures outlined in
344	344	Sections 166.045 and 166.046, Health and Safety Code, wilfully
345	345	fails to make a reasonable effort to transfer a patient to a
346	346	physician who is willing to comply with a directive; or
347	347	(18) [(23)] performs or delegates to another
348	348	individual the performance of a pelvic examination on an
349	349	anesthetized or unconscious patient in violation of Section
350	350	167A.002, Health and Safety Code[; or
351	351	[(24) performs a gender transitioning or gender
352	352	reassignment procedure or treatment in violation of Section
353	353	161.702, Health and Safety Code].
354	354	ARTICLE 3. CONFORMING AMENDMENTS
355	355	SECTION 3.01. Section 161.006(b), Family Code, is amended
356	356	to read as follows:
357	357	(b) In this code, "abortion" has the meaning assigned by
358	358	Section 171.002 [245.002], Health and Safety Code.
359	359	SECTION 3.02. Section 266.010(a), Family Code, is amended
360	360	to read as follows:
361	361	(a) A foster child who is at least 16 years of age may
362	362	consent to the provision of medical care[, except as provided by
363	363	Chapter 33,] if the court with continuing jurisdiction determines
364	364	that the child has the capacity to consent to medical care. If the
365	365	child provides consent by signing a consent form, the form must be
366	366	written in language the child can understand.
367	367	SECTION 3.03. Section 419.909(c), Government Code, is
368	368	amended to read as follows:
369	369	(c) This section does not apply to state agency personnel
370	370	who conduct a life safety code survey of a building or facility in
371	371	connection with determining whether to issue or renew a license
372	372	under Chapter 142, 241, 242, 243, 244, [245,] 247, 248, 251, 252,
373	373	464, 466, or 577, Health and Safety Code, or Chapter 103, Human
374	374	Resources Code.
375	375	SECTION 3.04. Section 32.046(e), Health and Safety Code, is
376	376	amended to read as follows:
377	377	(e) For purposes of this section, "postpartum depression"
378	378	means a disorder in which an individual [a woman] experiences
379	379	moderate to severe depression following a pregnancy, regardless of
380	380	whether the pregnancy resulted in birth, or an abortion [act]
381	381	defined by Section 171.002 [245.002(1)].
382	382	SECTION 3.05. Section 170.001(1), Health and Safety Code,
383	383	is amended to read as follows:
384	384	(1) "Abortion" has the meaning assigned by Section
385	385	171.002 [245.002].
386	386	SECTION 3.06. Section 241.011, Health and Safety Code, is
387	387	amended to read as follows:
388	388	Sec. 241.011. HUMAN TRAFFICKING SIGNS REQUIRED. (a) An
389	389	emergency department of a hospital shall display separate signs, in
390	390	English and Spanish, side by side in accordance with this section in
391	391	each restroom and patient consulting room. The signs must include
392	392	the following information:
393	393	(1) no person, including an individual's parents, may
394	394	force any individual to have an abortion;
395	395	(2) it is illegal for a person to force an individual
396	396	to engage in sexual acts;
397	397	(3) an individual who needs help may call or text a
398	398	state or national organization that assists victims of human
399	399	trafficking and forced abortions; and
400	400	(4) the toll-free number of an organization described
401	401	by Subdivision (3) [that comply with Section 245.025 as if the
402	402	hospital is an abortion facility].
403	403	(b) In addition to the information required under
404	404	Subsection (a), the sign must include the contact information for
405	405	reporting suspicious activity to the Department of Public Safety.
406	406	(c) Signs required under this section must be at least 8-1/2
407	407	by 11 inches in size and displayed in a conspicuous manner clearly
408	408	visible to the public and employees of a hospital. The notice must
409	409	cover at least four-fifths of the sign.
410	410	(d) The executive commissioner shall adopt rules as
411	411	necessary to implement and enforce this section.
412	412	SECTION 3.07. Section 248.003, Health and Safety Code, is
413	413	amended to read as follows:
414	414	Sec. 248.003. EXEMPTIONS. This chapter does not apply to:
415	415	(1) a home and community support services agency
416	416	required to be licensed under Chapter 142;
417	417	(2) a person required to be licensed under Chapter 241
418	418	(Texas Hospital Licensing Law);
419	419	(3) an institution required to be licensed under
420	420	Chapter 242;
421	421	(4) an ambulatory surgical center required to be
422	422	licensed under Chapter 243 (Texas Ambulatory Surgical Center
423	423	Licensing Act);
424	424	(5) a birthing center required to be licensed under
425	425	Chapter 244 (Texas Birthing Center Licensing Act);
426	426	(6) [a facility required to be licensed under Chapter
427	427	245 (Texas Abortion Facility Reporting and Licensing Act);
428	428	[(7)] a general residential operation, foster group
429	429	home, foster home, and child-placing agency, for children in foster
430	430	care or other residential care who are under the conservatorship of
431	431	the Department of Family and Protective Services; or
432	432	(7) [(8)] a person providing medical or nursing care
433	433	or services under a license or permit issued under other state law.
434	434	ARTICLE 4. REPEALER; TRANSITIONS; CONFLICTS; EFFECTIVE DATE
435	435	SECTION 4.01. The following provisions are repealed:
436	436	(1) Section 30.022, Civil Practice and Remedies Code;
437	437	(2) Subchapter L, Chapter 74, Civil Practice and
438	438	Remedies Code;
439	439	(3) Section 38.063(e-1), Education Code;
440	440	(4) Chapter 33, Family Code;
441	441	(5) Section 151.002, Family Code;
442	442	(6) Section 311.036, Government Code;
443	443	(7) Chapter 2273, Government Code;
444	444	(8) Section 32.005, Health and Safety Code;
445	445	(9) Chapter 54, Health and Safety Code, as added by
446	446	Chapter 1033 (S.B. 24), Acts of the 88th Legislature, Regular
447	447	Session, 2023;
448	448	(10) Section 62.151(g), Health and Safety Code;
449	449	(11) Subchapter X, Chapter 161, Health and Safety
450	450	Code, as added by Chapter 335 (S.B. 14), Acts of the 88th
451	451	Legislature, Regular Session, 2023;
452	452	(12) Chapter 170A, Health and Safety Code;
453	453	(13) Sections 171.002(2), (3), and (4), Health and
454	454	Safety Code;
455	455	(14) Section 171.0031, Health and Safety Code;
456	456	(15) Section 171.004, Health and Safety Code;
457	457	(16) Section 171.005, Health and Safety Code;
458	458	(17) Section 171.006, Health and Safety Code, as added
459	459	by Chapter 4 (H.B. 13), Acts of the 85th Legislature, First Called
460	460	Session, 2017;
461	461	(18) Section 171.006, Health and Safety Code, as added
462	462	by Chapter 9 (H.B. 215), Acts of the 85th Legislature, First Called
463	463	Session, 2017;
464	464	(19) Section 171.008, Health and Safety Code;
465	465	(20) Section 171.012, Health and Safety Code;
466	466	(21) Section 171.0121, Health and Safety Code;
467	467	(22) Section 171.0122, Health and Safety Code;
468	468	(23) Section 171.0123, Health and Safety Code;
469	469	(24) Section 171.0124, Health and Safety Code;
470	470	(25) Section 171.013, Health and Safety Code;
471	471	(26) Section 171.014, Health and Safety Code;
472	472	(27) Section 171.015, Health and Safety Code;
473	473	(28) Section 171.016, Health and Safety Code;
474	474	(29) Section 171.017, Health and Safety Code;
475	475	(30) Section 171.018, Health and Safety Code;
476	476	(31) Subchapters C, D, E, F, G, and H, Chapter 171,
477	477	Health and Safety Code;
478	478	(32) Section 241.007, Health and Safety Code;
479	479	(33) Section 243.017, Health and Safety Code;
480	480	(34) Chapter 245, Health and Safety Code;
481	481	(35) Section 285.202, Health and Safety Code;
482	482	(36) Chapter 697, Health and Safety Code;
483	483	(37) Section 32.024(c-1), Human Resources Code;
484	484	(38) Section 32.024(pp), Human Resources Code, as
485	485	added by Chapter 335 (S.B. 14), Acts of the 88th Legislature,
486	486	Regular Session, 2023;
487	487	(39) Section 1218.003, Insurance Code;
488	488	(40) Section 1218.005, Insurance Code;
489	489	(41) Section 1218.006, Insurance Code;
490	490	(42) Subtitle M, Title 8, Insurance Code;
491	491	(43) Chapter 103, Occupations Code;
492	492	(44) Section 111.005(c), Occupations Code;
493	493	(45) Section 164.055, Occupations Code;
494	494	(46) Section 164.0551, Occupations Code;
495	495	(47) Section 164.0552, Occupations Code;
496	496	(48) Section 9.35, Penal Code; and
497	497	(49) Chapter 6-1/2, Title 71, Revised Statutes.
498	498	SECTION 4.02. If before implementing any provision of this
499	499	Act a state agency determines that a waiver or authorization from a
500	500	federal agency is necessary for implementation of that provision,
501	501	the agency affected by the provision shall request the waiver or
502	502	authorization and may delay implementing that provision until the
503	503	waiver or authorization is granted.
504	504	SECTION 4.03. (a) Section 32.351, Human Resources Code, as
505	505	added by this Act, applies only to an initial determination or
506	506	recertification of eligibility of an individual for medical
507	507	assistance under Chapter 32, Human Resources Code, made on or after
508	508	the date the section is implemented, regardless of the date the
509	509	individual applied for that assistance.
510	510	(b) As soon as possible after the effective date of this
511	511	Act, the executive commissioner of the Health and Human Services
512	512	Commission shall take all necessary actions to expand eligibility
513	513	for medical assistance under Chapter 32, Human Resources Code, in
514	514	accordance with Section 32.351, Human Resources Code, as added by
515	515	this Act, including notifying appropriate federal agencies of that
516	516	expanded eligibility.
517	517	SECTION 4.04. Chapter 1218, Insurance Code, as amended by
518	518	this Act, applies only to a health benefit plan delivered, issued
519	519	for delivery, or renewed on or after January 1, 2026. A health
520	520	benefit plan delivered, issued for delivery, or renewed before
521	521	January 1, 2026, is governed by the law as it existed immediately
522	522	before the effective date of this Act, and that law is continued in
523	523	effect for that purpose.
524	524	SECTION 4.05. The changes in law made by this Act apply only
525	525	to health care services provided on or after the effective date of
526	526	this Act. Health care services provided before the effective date
527	527	of this Act are governed by the law applicable to those services
528	528	immediately before the effective date of this Act, and that law is
529	529	continued in effect for that purpose.
530	530	SECTION 4.06. To the extent of any conflict, this Act
531	531	prevails over another Act of the 89th Legislature, Regular Session,
532	532	2025, relating to nonsubstantive additions to and corrections in
533	533	enacted codes.
534	534	SECTION 4.07. This Act takes effect September 1, 2025.