H.B. No. 214

	AN ACT
	relating to health plan and health benefit plan coverage for
	elective abortion.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Title 8, Insurance Code, is amended by adding
	Subtitle M to read as follows:
	SUBTITLE M.  FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT
	CHAPTER 1695.  LEGISLATIVE CONSIDERATIONS
	Sec. 1695.001.  CONSTITUTIONALITY OF PATIENT PROTECTION AND
	AFFORDABLE CARE ACT. This subtitle does not constitute an
	acknowledgment by the legislature of the legitimacy of the Patient
	Protection and Affordable Care Act (Pub. L. No. 111-148) as a
	constitutional exercise of the power of the United States Congress.
	CHAPTER 1696.  COVERAGE FOR ELECTIVE ABORTION; PROHIBITIONS AND
	REQUIREMENTS
	Sec. 1696.001.  DEFINITIONS.  In this chapter:
	(1)  "Elective abortion" means an abortion, as defined
	by Section 245.002, Health and Safety Code, other than an abortion
	performed due to a medical emergency as defined by Section 171.002,
	Health and Safety Code.
	(2)  "Health benefit exchange" means an American Health
	Benefit Exchange administered by the federal government or created
	under Section 1311(b) of the Patient Protection and Affordable Care
	Act (42 U.S.C. Section 18031(b)).
	(3)  "Qualified health plan" has the meaning assigned
	by Section 1301(a) of the Patient Protection and Affordable Care
	Act (42 U.S.C. Section 18021(a)).
	Sec. 1696.002.  PROHIBITED COVERAGE THROUGH HEALTH BENEFIT
	EXCHANGE. (a) A qualified health plan offered through a health
	benefit exchange may not provide coverage for elective abortion.
	(b)  This section does not prevent a person from purchasing
	optional or supplemental coverage for elective abortion under a
	health benefit plan other than a qualified health plan offered
	through a health benefit exchange.
	SECTION 2.  Subtitle A, Title 8, Insurance Code, is amended
	by adding Chapter 1218 to read as follows:
	CHAPTER 1218. COVERAGE FOR ELECTIVE ABORTION; PROHIBITIONS AND
	REQUIREMENTS
	Sec. 1218.001.  DEFINITION. In this chapter, "elective
	abortion" means an abortion, as defined by Section 245.002, Health
	and Safety Code, other than an abortion performed due to a medical
	emergency as defined by Section 171.002, Health and Safety Code.
	Sec. 1218.002.  APPLICABILITY OF CHAPTER. (a)  This chapter
	applies only to a health benefit plan that provides benefits for
	medical or surgical expenses incurred as a result of a health
	condition, accident, or sickness, including an individual, group,
	blanket, or franchise insurance policy or insurance agreement, a
	group hospital service contract, or an individual or group evidence
	of coverage or similar coverage document that is offered by:
	(1)  an insurance company;
	(2)  a group hospital service corporation operating
	under Chapter 842;
	(3)  a fraternal benefit society operating under
	Chapter 885;
	(4)  a stipulated premium company operating under
	Chapter 884;
	(5)  an exchange operating under Chapter 942;
	(6)  a health maintenance organization operating under
	Chapter 843;
	(7)  a multiple employer welfare arrangement that holds
	a certificate of authority under Chapter 846; or
	(8)  an approved nonprofit health corporation that
	holds a certificate of authority under Chapter 844.
	(b)  This chapter applies to group health coverage made
	available by a school district in accordance with Section 22.004,
	Education Code.
	(c)  Notwithstanding any provision in Chapter 1551, 1575,
	1579, or 1601 or any other law, this chapter applies to:
	(1)  a basic coverage plan under Chapter 1551;
	(2)  a basic plan under Chapter 1575;
	(3)  a primary care coverage plan under Chapter 1579;
	and
	(4)  basic coverage under Chapter 1601.
	(d)  Notwithstanding Section 1501.251 or any other law, this
	chapter applies to coverage under a small or large employer health
	benefit plan subject to Chapter 1501.
	(e)  Notwithstanding Section 1507.003 or 1507.053 or any
	other law, this chapter applies to a standard health benefit plan
	provided under Chapter 1507.
	Sec. 1218.003.  CERTAIN COVERAGE NOT AFFECTED. This chapter
	does not apply to health benefit plan coverage provided to an
	enrollee for any abortion other than an elective abortion as
	defined by Section 1218.001.
	Sec. 1218.004.  COVERAGE BY HEALTH BENEFIT PLAN. A health
	benefit plan may provide coverage for elective abortion only if:
	(1)  the coverage is provided to an enrollee separately
	from other health benefit plan coverage offered by the health
	benefit plan issuer;
	(2)  the enrollee pays the premium for coverage for
	elective abortion separately from, and in addition to, the premium
	for other health benefit plan coverage, if any; and
	(3)  the enrollee provides a signature for coverage for
	elective abortion, separately and distinct from the signature
	required for other health benefit plan coverage, if any, provided
	to the enrollee by the health benefit plan issuer.
	Sec. 1218.005.  CALCULATION OF PREMIUM. (a)  A health
	benefit plan issuer that provides coverage for elective abortion
	shall calculate the premium for the coverage so that the premium
	fully covers the estimated cost of elective abortion per enrollee,
	determined on an actuarial basis.
	(b)  In calculating a premium under Subsection (a), the
	health benefit plan issuer may not take into account any cost
	savings in other health benefit plan coverage offered by the health
	benefit plan issuer that is estimated to result from coverage for
	elective abortion.
	(c)  A health benefit plan issuer may not provide a premium
	discount to or reduce the premium for an enrollee for other health
	benefit plan coverage on the basis that the enrollee has coverage
	for elective abortion.
	Sec. 1218.006.  NOTICE BY ISSUER. A health benefit plan
	issuer that provides coverage for elective abortion shall at the
	time of enrollment in other health benefit plan coverage provide
	each enrollee with a notice that:
	(1)  coverage for elective abortion is optional and
	separate from other health benefit plan coverage offered by the
	health benefit plan issuer;
	(2)  the premium cost for coverage for elective
	abortion is a premium paid separately from, and in addition to, the
	premium for other health benefit plan coverage offered by the
	health benefit plan issuer; and
	(3)  the enrollee may enroll in a health benefit plan
	without obtaining coverage for elective abortion.
	SECTION 3.  This Act applies only to a qualified health plan
	offered through a health benefit exchange or a health benefit plan
	that is delivered, issued for delivery, or renewed on or after April
	1, 2018. A qualified health plan offered through a health benefit
	exchange or a health benefit plan that is delivered, issued for
	delivery, or renewed before April 1, 2018, is governed by the law as
	it existed immediately before the effective date of this Act, and
	that law is continued in effect for that purpose.
	SECTION 4.  This Act takes effect December 1, 2017.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I certify that H.B. No. 214 was passed by the House on August
	9, 2017, by the following vote:  Yeas 92, Nays 46, 2 present, not
	voting.
	______________________________
	Chief Clerk of the House
	I certify that H.B. No. 214 was passed by the Senate on August
	13, 2017, by the following vote:  Yeas 20, Nays 10.
	______________________________
	Secretary of the Senate
	APPROVED:  _____________________
	Date
	_____________________
	Governor