As Introduced

130th General Assembly Regular Session 2013-2014

H. B. No. 351

Representative Becker 

Cosponsors: Representatives Hood, Adams, J., Young, Buchy 

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A BILL

To amend sections 9.04, 1739.05, and 5101.56 and to

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enact sections 1751.68 and 3923.591 of the Revised

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Code to prohibit insurers from offering coverage

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for abortion services.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 9.04, 1739.05, and 5101.56 be	5
amended and sections 1751.68 and 3923.591 be enacted to read as	6
follows:	7

Sec. 9.04.  (A) As used in this section:

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(1) "Nontherapeutic abortion" means an abortion that is	9
performed or induced when the life of the mother would not be	10
endangered if the fetus were carried to term or when the pregnancy	11
of the mother was not the result of rape or incest reported to a	12
law enforcement agencypatient has not been diagnosed with an	13
ectopic pregnancy.	14

(2) "Policy, contract, or plan" means a policy, contract, or	15
plan of one or more insurance companies, medical care	16
corporations, health care corporations, health maintenance	17
organizations, preferred provider organizations, or other entities	18
that provides health, medical, hospital, or surgical coverage,	19
benefits, or services to elected or appointed officers or	20
employees of the state or any political subdivision thereof.	21
"Policy, contract, or plan" includes a plan that is associated	22
with a self-insurance program and a policy, contract, or plan that	23
implements a collective bargaining agreement.	24

(3) "Political subdivision" means any body corporate and	25
politic that is responsible for governmental activities in a	26
geographic area smaller than the state, except that "political	27
subdivision" does not include either of the following:	28

(a) A municipal corporation;

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(b) A county that has adopted a charter under Section 3 of	30
Article X, Ohio Constitution, to the extent that it is exercising	31
the powers of local self-government as provided in that charter	32
and is subject to Section 3 of Article XVIII, Ohio Constitution.	33

(4) "State" means the state of Ohio, including the general	34
assembly, the supreme court, the offices of all elected state	35
officers, and all departments, boards, offices, commissions,	36
agencies, colleges and universities, institutions, and other	37
instrumentalities of the state of Ohio. "State" does not include	38
political subdivisions.	39

(B) Subject to division (C) of this section, but	40
notwithstanding other provisions of the Revised Code that conflict	41
with the prohibition specified in this division, funds of the	42
state or any political subdivision thereof shall not be expended	43
directly or indirectly to pay the costs, premiums, or charges	44
associated with a policy, contract, or plan if the policy,	45
contract, or plan provides coverage, benefits, or services related	46
to a nontherapeutic abortion.	47

(C) Division (B) of this section does not preclude the state	48
or any political subdivision thereof from expending funds to pay	49
the costs, premiums, or charges associated with a policy,	50
contract, or plan that includes a rider or other provision offered	51
on an individual basis under which an elected or appointed	52
official or employee who accepts the offer of the rider or	53
provision may obtain coverage of a nontherapeutic abortion through	54
the policy, contract, or plan if the individual pays for all of	55
the costs, premiums, or charges associated with the rider or	56
provision, including all administrative expenses related to the	57
rider or provision and any claim made for a nontherapeutic	58
abortion.	59

(D) In addition to the laws specified in division (A) of	60
section 4117.10 of the Revised Code that prevail over conflicting	61
provisions of agreements between employee organizations and public	62
employers, divisionsdivision (B) and (C) of this section shall	63
prevail over conflicting provisions of that nature.	64

Sec. 1739.05.  (A) A multiple employer welfare arrangement	65
that is created pursuant to sections 1739.01 to 1739.22 of the	66
Revised Code and that operates a group self-insurance program may	67
be established only if any of the following applies:	68

(1) The arrangement has and maintains a minimum enrollment of	69
three hundred employees of two or more employers.	70

(2) The arrangement has and maintains a minimum enrollment of	71
three hundred self-employed individuals.	72

(3) The arrangement has and maintains a minimum enrollment of	73
three hundred employees or self-employed individuals in any	74
combination of divisions (A)(1) and (2) of this section.	75

(B) A multiple employer welfare arrangement that is created	76
pursuant to sections 1739.01 to 1739.22 of the Revised Code and	77
that operates a group self-insurance program shall comply with all	78
laws applicable to self-funded programs in this state, including	79
sections 3901.04, 3901.041, 3901.19 to 3901.26, 3901.38, 3901.381	80
to 3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to 3902.14,	81
3923.24, 3923.282, 3923.30, 3923.301, 3923.38, 3923.581, 3923.591,	82
3923.63, 3923.80, 3924.031, 3924.032, and 3924.27 of the Revised	83
Code.	84

(C) A multiple employer welfare arrangement created pursuant	85
to sections 1739.01 to 1739.22 of the Revised Code shall solicit	86
enrollments only through agents or solicitors licensed pursuant to	87
Chapter 3905. of the Revised Code to sell or solicit sickness and	88
accident insurance.	89

(D) A multiple employer welfare arrangement created pursuant	90
to sections 1739.01 to 1739.22 of the Revised Code shall provide	91
benefits only to individuals who are members, employees of	92
members, or the dependents of members or employees, or are	93
eligible for continuation of coverage under section 1751.53 or	94
3923.38 of the Revised Code or under Title X of the "Consolidated	95
Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29	96
U.S.C.A. 1161, as amended.	97

Sec. 1751.68.  (A) A health insuring corporation shall not	98
provide coverage for abortion services under any policy, contract,	99
or agreement that is issued, delivered, or renewed in this state.	100

(B) Nothing in this section shall be interpreted as	101
prohibiting coverage, or enabling an insurer to deny coverage, for	102
the treatment of any post-abortion complication.	103

(C) As used in this section, "abortion services" includes	104
drugs or devices used to prevent the implantation of a fertilized	105
ovum. "Abortion services" does not include treatment or services	106
related to an ectopic pregnancy, commonly referred to as a "tubal	107
pregnancy."	108

Sec. 3923.591.  (A) A sickness and accident insurer and a	109
public employee benefit plan shall not provide coverage for	110
abortion services under any policy of individual or group sickness	111
and accident insurance or under any public employee benefit plan.	112

(B) Nothing in this section shall be interpreted as	113
prohibiting coverage, or enabling an insurer to deny coverage, for	114
the treatment of any post-abortion complication.	115

(C) As used in this section, "abortion services" includes	116
drugs or devices used to prevent the implantation of a fertilized	117
ovum. "Abortion services" does not include treatment or services	118
related to an ectopic pregnancy, commonly referred to as a "tubal	119
pregnancy."	120

Sec. 5101.56. (A) As used in this section, "physician" means	121
a person who holds a valid certificate to practice medicine and	122
surgery or osteopathic medicine and surgery issued under Chapter	123
4731. of the Revised Code.	124

(B) Unless required by the United States Constitution or by	125
federal statute, regulation, or decisions of federal courts, state	126
or local funds may not be used for payment or reimbursement for	127
abortion services unless the certification required by division	128
(C) of this section is made and one of the following circumstances	129
exists:	130

(1) Thethe woman suffers from a physical disorder, physical	131
injury, or physical illness, including a life-endangering physical	132
condition caused by or arising from the pregnancy, that would, as	133
certified by a physician, place the woman in danger of death	134
unless an abortion is performed.	135

(2) The pregnancy was the result of an act of rape and the	136
patient, the patient's legal guardian, or the person who made the	137
report to the law enforcement agency, certifies in writing that	138
prior to the performance of the abortion a report was filed with a	139
law enforcement agency having the requisite jurisdiction, unless	140
the patient was physically unable to comply with the reporting	141
requirement and that fact is certified by the physician performing	142
the abortion.	143

(3) The pregnancy was the result of an act of incest and the	144
patient, the patient's legal guardian, or the person who made the	145
report certifies in writing that prior to the performance of the	146
abortion a report was filed with either a law enforcement agency	147
having the requisite jurisdiction, or, in the case of a minor,	148
with a county children services agency established under Chapter	149
5153. of the Revised Code, unless the patient was physically	150
unable to comply with the reporting requirement and that fact is	151
certified by the physician performing the abortionis diagnosed	152
with an ectopic pregnancy, commonly referred to as a "tubal	153
pregnancy."	154

(C)(1) Before payment of or reimbursement for an abortion can	155
be made with state or local funds, the physician performing the	156
abortion shall certify that one of the three circumstances in	157
division (B) of this section has occurredthe patient in question	158
has been diagnosed with an ectopic pregnancy. The certification	159
shall be made on a form created by the Ohio department of job and	160
family services known as the "Abortion Certification Form." The	161
physician's signature shall be in the physician's own handwriting.	162
The certification shall list the name and address of the patient.	163
The certification form shall be attached to the billing invoice.	164

(2) The certification shall be as follows:

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I certify that, on the basis of my professional judgment,	166
this service was necessary because:	167

(a) The woman suffers from a physical disorder, physical	168
injury, or physical illness, including a life-endangering physical	169
condition caused by or arising from the pregnancy itself, that	170
would place the woman in danger of death unless an abortion was	171
performed;	172

(b) The pregnancy was the result of an act of rape and the	173
patient, the patient's legal guardian, or the person who made the	174
report to the law enforcement agency certified in writing that	175
prior to the performance of the abortion a report was filed with a	176
law enforcement agency having the requisite jurisdiction;	177

(c) The pregnancy was the result of an act of incest and the	178
patient, the patient's legal guardian, or the person who made the	179
report certified in writing that prior to the performance of the	180
abortion a report was filed with either a law enforcement agency	181
having the requisite jurisdiction or, in the case of a minor, with	182
a county children services agency established under Chapter 5153.	183
of the Revised Code;	184

(d) The pregnancy was the result of an act of rape and in my	185
professional opinion the recipient was physically unable to comply	186
with the reporting requirement; or	187

(e) The pregnancy was a result of an act of incest and in my	188
professional opinion the recipient was physically unable to comply	189
with the reporting requirementthe patient in question was	190
diagnosed with an ectopic pregnancy.	191

(D) Payment or reimbursement for abortion services shall not	192
be made with state or local funds for associated services such as	193
anesthesia, laboratory tests, or hospital services if the abortion	194
service itself cannot be paid or reimbursed with state or local	195
funds. All abortion services for which a physician is seeking	196
reimbursement or payment for the purposes of this division shall	197
be submitted on a hard-copy billing invoice.	198

(E) Documentation that supports the certification made by a	199
physician shall be maintained by the physician in the recipient's	200
medical record. When the physician certifies that circumstances	201
described in division (C)(2)(b) or (c) of this section are the	202
case, a copy of the statement signed by the patient, the patient's	203
legal guardian, or the person who made the report shall be	204
maintained in the patient's medical record.	205

(F) Nothing in this section deniesState or local funds shall	206
not be used for reimbursement for drugs or devices to prevent	207
implantation of the fertilized ovum, or for medical procedures for	208
the termination of an ectopic pregnancy..	209

(G) This section does not apply to treatments for incomplete,	210
missed, or septic abortions.	211

(G)(H) If enforcement of this section will adversely affect	212
eligibility of the state or a political subdivision of the state	213
for participation in a federal program, this section shall be	214
enforced to the extent permissible without preventing	215
participation in that federal program.	216

Section 2.  That existing sections 9.04, 1739.05, and 5101.56	217
of the Revised Code are hereby repealed.	218

Section 3. This act applies to policies, contracts,	219
agreements, and plans that are issued, delivered, modified, or	220
renewed on or after the effective date of this act.	221