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A BILL TO BE ENTITLED
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AN ACT
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relating to abortion complication reporting and the regulation of |
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drug-induced abortion procedures, providers, and facilities; |
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creating a criminal offense. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The legislature finds that: |
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(1) this state has an interest in protecting the |
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health and welfare of every woman considering a drug-induced |
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abortion; |
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(2) the use of Mifeprex or mifepristone presents |
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significant medical complications including, but not limited to, |
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uterine hemorrhage, viral infections, abdominal pain, cramping, |
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vomiting, headache, fatigue, and pelvic inflammatory disease; and |
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(3) the failure rate and risk of complications |
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increases with advancing gestational age. |
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SECTION 2. Sections 171.006(a) and (b), Health and Safety |
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Code, as added by Chapter 4 (H.B. 13), Acts of the 85th Legislature, |
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1st Called Session, 2017, are amended to read as follows: |
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(a) In this section, "abortion complication" or "adverse |
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event" means any harmful event or adverse outcome with respect to a |
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patient related to an abortion that is performed or induced on the |
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patient and that is diagnosed or treated by a health care |
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practitioner or at a health care facility and includes: |
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(1) shock; |
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(2) uterine perforation; |
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(3) cervical laceration; |
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(4) hemorrhage; |
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(5) aspiration or allergic response; |
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(6) infection; |
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(7) sepsis; |
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(8) death of the patient; |
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(9) incomplete abortion; |
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(10) damage to the uterus; [or] |
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(11) an infant born alive after the abortion; |
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(12) blood clots resulting in pulmonary embolism or |
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deep vein thrombosis; |
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(13) failure to actually terminate the pregnancy; |
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(14) pelvic inflammatory disease; |
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(15) endometritis; |
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(16) missed ectopic pregnancy; |
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(17) cardiac arrest; |
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(18) respiratory arrest; |
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(19) renal failure; |
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(20) metabolic disorder; |
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(21) embolism; |
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(22) coma; |
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(23) placenta previa in subsequent pregnancies; |
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(24) preterm delivery in subsequent pregnancies; |
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(25) fluid accumulation in the abdomen; |
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(26) hemolytic reaction resulting from the |
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administration of ABO-incompatible blood or blood products; |
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(27) adverse reactions to anesthesia or other drugs; |
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or |
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(28) any other adverse event as defined by the United |
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States Food and Drug Administration's criteria provided by the |
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MedWatch Reporting System. |
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(b) The reporting requirements of this section apply only |
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to: |
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(1) a physician who: |
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(A) performs or induces at an abortion facility |
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an abortion that results in an abortion complication diagnosed or |
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treated by that physician; or |
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(B) diagnoses or treats [at an abortion facility] |
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an abortion complication that is the result of an abortion |
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performed or induced by another physician [at the facility]; or |
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(2) a health care facility that is a hospital, |
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abortion facility, freestanding emergency medical care facility, |
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or health care facility that provides emergency medical care, as |
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defined by Section 773.003. |
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SECTION 3. Section 171.061, Health and Safety Code, is |
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amended by amending Subdivisions (2) and (5) and adding |
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Subdivisions (2-a) and (8-a) to read as follows: |
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(2) "Abortion-inducing drug" means a drug, a medicine, |
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or any other substance, including a regimen of two or more drugs, |
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medicines, or substances, prescribed, dispensed, or administered |
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with the intent of terminating a clinically diagnosable pregnancy |
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of a woman and with knowledge that the termination will, with |
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reasonable likelihood, cause the death of the woman's unborn child. |
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The term includes off-label use of drugs, medicines, or other |
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substances known to have abortion-inducing properties that are |
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prescribed, dispensed, or administered with the intent of causing |
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an abortion, including the Mifeprex regimen, misoprostol |
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(Cytotec), and methotrexate. The term does not include a drug, |
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medicine, or other substance that may be known to cause an abortion |
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but is prescribed, dispensed, or administered for other medical |
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reasons. |
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(2-a) "Adverse event" or "abortion complication" |
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means any harmful event or adverse outcome with respect to a patient |
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related to an abortion, including the abortion complications listed |
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in Section 171.006, as added by Chapter 4 (H.B. 13), Acts of the |
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85th Legislature, 1st Called Session, 2017. |
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(5) "Medical abortion" means the administration or use |
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of an abortion-inducing drug to induce an abortion, and may also be |
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referred to as a "medication abortion," a "chemical abortion," a |
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"drug-induced abortion," "RU-486," or the "Mifeprex regimen". |
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(8-a) "Provide" means, as used with regard to |
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abortion-inducing drugs, any act of giving, selling, dispensing, |
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administering, transferring possession, or otherwise providing or |
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prescribing an abortion-inducing drug. |
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SECTION 4. Section 171.063, Health and Safety Code, is |
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amended by amending Subsections (a), (c), and (e) and adding |
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Subsection (b-1) to read as follows: |
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(a) A person may not knowingly [give, sell, dispense, |
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administer,] provide[, or prescribe] an abortion-inducing drug to a |
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pregnant woman for the purpose of inducing an abortion in the |
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pregnant woman or enabling another person to induce an abortion in |
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the pregnant woman unless: |
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(1) the person who [gives, sells, dispenses, |
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administers,] provides[, or prescribes] the abortion-inducing drug |
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is a physician; and |
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(2) [except as otherwise provided by Subsection (b),] |
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the provision[, prescription, or administration] of the |
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abortion-inducing drug satisfies the protocol [tested and] |
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authorized by this subchapter [the United States Food and Drug |
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Administration as outlined in the final printed label of the |
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abortion-inducing drug]. |
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(b-1) A manufacturer, supplier, physician, or any other |
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person may not provide to a patient any abortion-inducing drug by |
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courier, delivery, or mail service. |
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(c) Before the physician [gives, sells, dispenses, |
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administers,] provides[, or prescribes] an abortion-inducing drug, |
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the physician must: |
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(1) examine the pregnant woman in person; |
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(2) independently verify that a pregnancy exists; |
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(3) [and] document, in the woman's medical record, the |
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gestational age and intrauterine location of the pregnancy to |
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determine whether an ectopic pregnancy exists; |
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(4) determine the pregnant woman's blood type, and for |
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a woman who is Rh negative, offer to administer Rh immunoglobulin |
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(RhoGAM) at the time the abortion-inducing drug is administered or |
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the abortion is performed or induced to prevent Rh incompatibility, |
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complications, or miscarriage in future pregnancies; |
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(5) document whether the pregnant woman received |
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treatment for Rh negativity, as diagnosed by the most accurate |
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standard of medical care; and |
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(6) ensure the physician does not provide an |
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abortion-inducing drug for a pregnant woman whose pregnancy is more |
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than 49 days of gestational age. |
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(e) A [The] physician who [gives, sells, dispenses, |
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administers,] provides[, or prescribes] the abortion-inducing |
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drug, or the physician's agent, must schedule a follow-up visit for |
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the woman to occur not later [more] than the 14th day [14 days] |
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after the earliest date on which the abortion-inducing drug is |
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administered [administration] or used or the abortion is performed |
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or induced [use of the drug]. At the follow-up visit, the physician |
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must: |
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(1) confirm that the woman's pregnancy is completely |
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terminated; and |
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(2) assess any continued blood loss [the degree of |
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bleeding]. |
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SECTION 5. Subchapter D, Chapter 171, Health and Safety |
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Code, is amended by adding Sections 171.0631, 171.0632, 171.065, |
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and 171.066 to read as follows: |
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Sec. 171.0631. VOLUNTARY AND INFORMED CONSENT REQUIRED. A |
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person may not provide an abortion-inducing drug to a pregnant |
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woman without satisfying the applicable informed consent |
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requirements of Subchapter B. |
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Sec. 171.0632. REPORTING REQUIREMENTS. A physician who |
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provides an abortion-inducing drug must comply with the applicable |
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physician reporting requirements under Section 245.011. |
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Sec. 171.065. CRIMINAL OFFENSE. (a) A person who |
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intentionally, knowingly, or recklessly violates this subchapter |
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commits an offense. An offense under this subsection is a state |
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jail felony. |
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(b) A pregnant woman on whom a drug-induced abortion is |
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attempted, induced, or performed in violation of this subchapter is |
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not criminally liable for the violation. |
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(c) Conduct constituting an offense under this section may |
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also be the basis for an administrative violation under Section |
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171.064. |
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Sec. 171.066. ENFORCEMENT OF SUBCHAPTER. A state executive |
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or administrative official may not decline to enforce this |
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subchapter, or adopt a construction of this subchapter in a way that |
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narrows its applicability, based on the official's own beliefs on |
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the requirements of the state or federal constitution, unless the |
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official is enjoined by a state or federal court from enforcing this |
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subchapter. |
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SECTION 6. The following provisions of the Health and |
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Safety Code are repealed: |
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(1) Sections 171.061(3) and (6); and |
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(2) Section 171.063(b). |
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SECTION 7. (a) Nothing in this Act shall be construed as |
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creating or recognizing a right to abortion. |
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(b) It is not the intention of this Act to make lawful an |
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abortion that is otherwise unlawful. |
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(c) Except as specifically provided by Section 6 of this |
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Act, nothing in this Act repeals, replaces, or otherwise |
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invalidates existing Texas laws, regulations, or policies. |
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SECTION 8. Any provision of this Act held to be invalid or |
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unenforceable by its terms or as applied to any person or |
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circumstance shall be construed to give the provision the maximum |
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effect permitted by law, unless such holding is one of utter |
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invalidity or unenforceability, in which event the provision shall |
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be considered severable from the other provisions of this Act and |
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shall not affect the remainder or the application of the provisions |
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to other persons not similarly situated or to other, dissimilar |
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circumstances. |
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SECTION 9. (a) Except as provided by Subsection (b) of this |
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section, the changes in law made by this Act apply only to an |
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abortion performed or induced on or after the effective date of this |
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Act. |
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(b) Section 171.065, Health and Safety Code, as added by |
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this Act, applies only to an abortion performed or induced on or |
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after December 1, 2021. |
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SECTION 10. This Act takes effect immediately if it |
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receives a vote of two-thirds of all the members elected to each |
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house, as provided by Section 39, Article III, Texas Constitution. |
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If this Act does not receive the vote necessary for immediate |
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effect, this Act takes effect on the 91st day after the last day of |
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the legislative session. |
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* * * * * |