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A BILL TO BE ENTITLED
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AN ACT
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relating to health plan and health benefit plan coverage for |
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elective abortion. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Title 8, Insurance Code, is amended by adding |
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Subtitle M to read as follows: |
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SUBTITLE M. FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT |
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CHAPTER 1695. LEGISLATIVE CONSIDERATIONS |
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Sec. 1695.001. CONSTITUTIONALITY OF PATIENT PROTECTION AND |
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AFFORDABLE CARE ACT. This subtitle does not constitute an |
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acknowledgment by the legislature of the legitimacy of the Patient |
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Protection and Affordable Care Act (Pub. L. No. 111-148) as a |
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constitutional exercise of the power of the United States Congress. |
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CHAPTER 1696. COVERAGE FOR ELECTIVE ABORTION; PROHIBITIONS AND |
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REQUIREMENTS |
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Sec. 1696.001. DEFINITIONS. In this chapter: |
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(1) "Elective abortion" means an abortion, as defined |
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by Section 245.002, Health and Safety Code, other than an abortion |
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performed due to a medical emergency as defined by Section 171.002, |
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Health and Safety Code. |
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(2) "Health benefit exchange" means an American Health |
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Benefit Exchange administered by the federal government or created |
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under Section 1311(b) of the Patient Protection and Affordable Care |
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Act (42 U.S.C. Section 18031(b)). |
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(3) "Qualified health plan" has the meaning assigned |
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by Section 1301(a) of the Patient Protection and Affordable Care |
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Act (42 U.S.C. Section 18021(a)). |
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Sec. 1696.002. PROHIBITED COVERAGE THROUGH HEALTH BENEFIT |
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EXCHANGE. (a) A qualified health plan offered through a health |
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benefit exchange may not provide coverage for elective abortion. |
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(b) This section does not prevent a person from purchasing |
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optional or supplemental coverage for elective abortion under a |
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health benefit plan other than a qualified health plan offered |
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through a health benefit exchange. |
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SECTION 2. Subtitle A, Title 8, Insurance Code, is amended |
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by adding Chapter 1218 to read as follows: |
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CHAPTER 1218. COVERAGE FOR ELECTIVE ABORTION; PROHIBITIONS AND |
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REQUIREMENTS |
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Sec. 1218.001. DEFINITION. In this chapter, "elective |
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abortion" means an abortion, as defined by Section 245.002, Health |
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and Safety Code, other than an abortion performed due to a medical |
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emergency as defined by Section 171.002, Health and Safety Code. |
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Sec. 1218.002. APPLICABILITY OF CHAPTER. (a) This chapter |
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applies only to a health benefit plan that provides benefits for |
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medical or surgical expenses incurred as a result of a health |
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condition, accident, or sickness, including an individual, group, |
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blanket, or franchise insurance policy or insurance agreement, a |
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group hospital service contract, or an individual or group evidence |
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of coverage or similar coverage document that is offered by: |
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(1) an insurance company; |
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(2) a group hospital service corporation operating |
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under Chapter 842; |
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(3) a fraternal benefit society operating under |
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Chapter 885; |
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(4) a stipulated premium company operating under |
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Chapter 884; |
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(5) an exchange operating under Chapter 942; |
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(6) a health maintenance organization operating under |
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Chapter 843; |
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(7) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; or |
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(8) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844. |
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(b) This chapter applies to group health coverage made |
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available by a school district in accordance with Section 22.004, |
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Education Code. |
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(c) Notwithstanding any provision in Chapter 1551, 1575, |
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1579, or 1601 or any other law, this chapter applies to: |
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(1) a basic coverage plan under Chapter 1551; |
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(2) a basic plan under Chapter 1575; |
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(3) a primary care coverage plan under Chapter 1579; |
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and |
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(4) basic coverage under Chapter 1601. |
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(d) Notwithstanding Section 1501.251 or any other law, this |
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chapter applies to coverage under a small or large employer health |
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benefit plan subject to Chapter 1501. |
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(e) Notwithstanding Section 1507.003 or 1507.053 or any |
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other law, this chapter applies to a standard health benefit plan |
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provided under Chapter 1507. |
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Sec. 1218.003. CERTAIN COVERAGE NOT AFFECTED. This chapter |
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does not apply to health benefit plan coverage provided to an |
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enrollee for any abortion other than an elective abortion as |
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defined by Section 1218.001. |
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Sec. 1218.004. COVERAGE BY HEALTH BENEFIT PLAN. A health |
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benefit plan may provide coverage for elective abortion only if: |
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(1) the coverage is provided to an enrollee separately |
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from other health benefit plan coverage offered by the health |
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benefit plan issuer; |
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(2) the enrollee pays the premium for coverage for |
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elective abortion separately from, and in addition to, the premium |
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for other health benefit plan coverage, if any; and |
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(3) the enrollee provides a signature for coverage for |
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elective abortion, separately and distinct from the signature |
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required for other health benefit plan coverage, if any, provided |
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to the enrollee by the health benefit plan issuer. |
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Sec. 1218.005. CALCULATION OF PREMIUM. (a) A health |
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benefit plan issuer that provides coverage for elective abortion |
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shall calculate the premium for the coverage so that the premium |
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fully covers the estimated cost of elective abortion per enrollee, |
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determined on an actuarial basis. |
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(b) In calculating a premium under Subsection (a), the |
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health benefit plan issuer may not take into account any cost |
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savings in other health benefit plan coverage offered by the health |
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benefit plan issuer that is estimated to result from coverage for |
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elective abortion. |
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(c) A health benefit plan issuer may not provide a premium |
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discount to or reduce the premium for an enrollee for other health |
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benefit plan coverage on the basis that the enrollee has coverage |
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for elective abortion. |
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Sec. 1218.006. NOTICE BY ISSUER. A health benefit plan |
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issuer that provides coverage for elective abortion shall at the |
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time of enrollment in other health benefit plan coverage provide |
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each enrollee with a notice that: |
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(1) coverage for elective abortion is optional and |
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separate from other health benefit plan coverage offered by the |
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health benefit plan issuer; |
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(2) the premium cost for coverage for elective |
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abortion is a premium paid separately from, and in addition to, the |
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premium for other health benefit plan coverage offered by the |
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health benefit plan issuer; and |
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(3) the enrollee may enroll in a health benefit plan |
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without obtaining coverage for elective abortion. |
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SECTION 3. This Act applies only to a qualified health plan |
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offered through a health benefit exchange or a health benefit plan |
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that is delivered, issued for delivery, or renewed on or after April |
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1, 2018. A qualified health plan offered through a health benefit |
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exchange or a health benefit plan that is delivered, issued for |
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delivery, or renewed before April 1, 2018, is governed by the law as |
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it existed immediately before the effective date of this Act, and |
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that law is continued in effect for that purpose. |
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SECTION 4. This Act takes effect December 1, 2017. |
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* * * * * |