Texas 2025 - 89th Regular

Texas Senate Bill SB359 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R2042 SCL-F
2	2	By: Eckhardt, et al. S.B. No. 359
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the coverage and provision of abortion, contraception,
10	10	and sterilization under Medicaid and certain health benefit plans.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 32.024(e), Human Resources Code, is
13	13	amended to read as follows:
14	14	(e) Except as provided by Section 32.03118, the [The]
15	15	commission may not authorize the provision of any service to any
16	16	person under the program unless federal matching funds are
17	17	available to pay the cost of the service.
18	18	SECTION 2. Subchapter B, Chapter 32, Human Resources Code,
19	19	is amended by adding Section 32.03118 to read as follows:
20	20	Sec. 32.03118. REIMBURSEMENT FOR CERTAIN REPRODUCTIVE
21	21	HEALTH SERVICES. (a) Regardless of whether federal matching funds
22	22	are available to pay the cost of the services, the commission shall
23	23	ensure that medical assistance reimbursement is provided for the
24	24	provision of the following services to medical assistance
25	25	recipients:
26	26	(1) abortion services;
27	27	(2) forms of contraception approved by the United
28	28	States Food and Drug Administration, including the insertion and
29	29	removal of devices; and
30	30	(3) voluntary sterilization, including vasectomies.
31	31	(b) The commission shall ensure that abortion,
32	32	contraception, and sterilization services are provided in
33	33	accordance with applicable state and federal law.
34	34	(c) Notwithstanding any other law, abortion, contraception,
35	35	and sterilization services provided under the medical assistance
36	36	program may not be subject to:
37	37	(1) a cost-sharing requirement, including a
38	38	deductible or coinsurance;
39	39	(2) utilization review;
40	40	(3) a prior authorization or step-therapy
41	41	requirement; or
42	42	(4) any restrictions on or delays in coverage.
43	43	SECTION 3. The heading to Chapter 1218, Insurance Code, is
44	44	amended to read as follows:
45	45	CHAPTER 1218. COVERAGE FOR REPRODUCTIVE HEALTH SERVICES [ELECTIVE
46	46	ABORTION; PROHIBITIONS AND REQUIREMENTS]
47	47	SECTION 4. Sections 1218.001 and 1218.004, Insurance Code,
48	48	are amended to read as follows:
49	49	Sec. 1218.001. DEFINITIONS [DEFINITION]. In this chapter:
50	50	(1) "Abortion" has the meaning assigned[, "elective
51	51	abortion" means an abortion, as defined] by Section 245.002, Health
52	52	and Safety Code[, other than an abortion performed due to a medical
53	53	emergency as defined by Section 171.002, Health and Safety Code].
54	54	(2) "Effective pain and anxiety management" means
55	55	evidence-based pain and anxiety management, including prescription
56	56	anti-anxiety medication, local anesthesia, topical anesthetic,
57	57	paracervical block, and minimal and moderate sedation.
58	58	Sec. 1218.004. COVERAGE REQUIRED [BY HEALTH BENEFIT
59	59	PLAN]. (a) A health benefit plan shall [may] provide coverage for
60	60	abortion services, all forms of contraception approved by the
61	61	United States Food and Drug Administration, including the insertion
62	62	and removal of devices, counseling on effective pain and anxiety
63	63	management for the insertion or removal of devices, and provision
64	64	of effective pain and anxiety management for the insertion or
65	65	removal of devices, and voluntary sterilization, including
66	66	vasectomies, in accordance with applicable state and federal law.
67	67	(b) Coverage required under this section is not subject to
68	68	[elective abortion only if]:
69	69	(1) a cost-sharing requirement, including a
70	70	deductible or coinsurance [the coverage is provided to an enrollee
71	71	separately from other health benefit plan coverage offered by the
72	72	health benefit plan issuer];
73	73	(2) utilization review [the enrollee pays the premium
74	74	for coverage for elective abortion separately from, and in addition
75	75	to, the premium for other health benefit plan coverage, if any];
76	76	[and]
77	77	(3) a prior authorization or step-therapy
78	78	requirement; or
79	79	(4) any restrictions on or delays in coverage [the
80	80	enrollee provides a signature for coverage for elective abortion,
81	81	separately and distinct from the signature required for other
82	82	health benefit plan coverage, if any, provided to the enrollee by
83	83	the health benefit plan issuer].
84	84	(c) This section controls over Subchapter C, Chapter 1369,
85	85	to the extent of any conflict.
86	86	SECTION 5. The following provisions are repealed:
87	87	(1) Section 32.005, Health and Safety Code;
88	88	(2) Section 32.024(c-1), Human Resources Code;
89	89	(3) Sections 1218.003, 1218.005, and 1218.006,
90	90	Insurance Code; and
91	91	(4) Subtitle M, Title 8, Insurance Code.
92	92	SECTION 6. If before implementing any provision of this Act
93	93	a state agency determines that a waiver or authorization from a
94	94	federal agency is necessary for implementation of that provision,
95	95	the agency affected by the provision shall request the waiver or
96	96	authorization and may delay implementing that provision until the
97	97	waiver or authorization is granted.
98	98	SECTION 7. Chapter 1218, Insurance Code, as amended by this
99	99	Act, applies only to a health benefit plan delivered, issued for
100	100	delivery, or renewed on or after January 1, 2026. A health benefit
101	101	plan delivered, issued for delivery, or renewed before January 1,
102	102	2026, is governed by the law as it existed immediately before the
103	103	effective date of this Act, and that law is continued in effect for
104	104	that purpose.
105	105	SECTION 8. This Act takes effect September 1, 2025.