By: Eckhardt	S.B. No. 1623

	A BILL TO BE ENTITLED
	AN ACT
	relating to the coverage and provision of abortion and
	contraception under a health benefit plan and certain programs
	administered by this state.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Section 32.024, Human Resources Code, is amended
	by amending Subsection (e) and adding Subsection (mm) to read as
	follows:
	(e)  The commission may not authorize the provision of any
	service to any person under the program unless federal matching
	funds are available to pay the cost of the service, except that the
	commission shall provide abortion services and all FDA approved
	forms of contraception, including device insertion and removal and
	voluntary sterilization including vasectomies regardless of
	whether federal matching funds are available to pay for the cost of
	those services.
	(mm)  The commission shall provide abortion services and
	contraception under the medical assistance program in accordance
	with applicable state and federal law.
	(1)Notwithstanding any other provision in this code,
	abortion contraception and sterilization services shall not be
	subject to:
	(a)  any cost sharing for those services, including
	deductible or coinsurance.
	(b)  utilization review
	(c)  prior authorization or step-therapy requirements;
	or
	(d)  any restrictions or delays on the coverage.
	SECTION 2.  Chapter 1218 Insurance Code, is amended to read
	as follows:
	CHAPTER 1218.  COVERAGE FOR ELECTIVE ABORTION AND
	CONTRACEPTION; 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 REQUIRED BY HEALTH BENEFIT PLAN.  A
	health benefit plan shallmay provide coverage for elective
	abortion and all FDA approved forms of contraception, including
	device insertion and removal and voluntary sterilization including
	vasectomies only if: not subject to
	(1)  any cost sharing for those services, including
	deductible or coinsurance. the coverage is provided to an enrollee
	separately from other health benefit plan coverage offered by the
	health benefit plan issuer;
	(2)  utilization review 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)  prior authorization or step-therapy requirements; or
	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.
	(4)  any restrictions or delays on the coverage.
	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 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 in 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 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.  The following provisions are repealed:
	(1)  Section 32.005, Health and Safety Code;
	(2)  Section 32.024(c-1), Human Resources Code;
	(3)  Subtitle M, Title 8, Insurance Code.
	SECTION 4.  If before implementing any provision of this Act
	a state agency determines that a waiver or authorization from a
	federal agency is necessary for implementation of that provision,
	the agency affected by the provision shall request the waiver or
	authorization and may delay implementing that provision until the
	waiver or authorization is granted.
	SECTION 5.  This Act takes effect September 1, 2023.