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A BILL TO BE ENTITLED
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AN ACT
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relating to civil liability for, governmental health plan coverage |
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of, and public funding for gender modification procedures and |
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treatments. |
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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) as evidenced by a 2018 video of a Vanderbilt |
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University Medical Center administrator who promoted gender |
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modification surgeries as financially beneficial and stated that |
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entire clinics are being financed by phalloplasties, the medical |
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community has knowledge that many so-called "gender affirming" |
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treatments are not in the best interest of the health of the patient |
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but rather are being promoted for the monetary gain the health care |
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facilities will receive from providing those treatments; and |
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(2) the medical community has a conflict of interest |
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in offering gender modification treatments and procedures because |
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those treatments and procedures create lifelong patients as a |
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result of required follow-up visits after those treatments and |
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procedures. |
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SECTION 2. Title 4, Civil Practice and Remedies Code, is |
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amended by adding Chapter 74B to read as follows: |
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CHAPTER 74B. LIABILITY FOR GENDER MODIFICATION PROCEDURES AND |
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TREATMENTS |
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Sec. 74B.001. DEFINITION. In this chapter, "gender |
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modification procedure or treatment" means a health care procedure |
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or treatment provided for the purpose of transitioning a patient's |
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biological sex, as determined by the patient's sex organs, |
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chromosomes, and endogenous profiles, or affirming the patient's |
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perception of the patient's sex if that perception is inconsistent |
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with the patient's sex. The term includes: |
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(1) a surgery that sterilizes the patient, including: |
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(A) castration; |
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(B) vasectomy; |
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(C) hysterectomy; |
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(D) oophorectomy; |
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(E) metoidioplasty; |
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(F) orchiectomy; |
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(G) penectomy; |
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(H) phalloplasty; and |
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(I) vaginoplasty; |
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(2) a mastectomy; |
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(3) the prescription, administration, or supply of any |
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of the following medications that induce transient or permanent |
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infertility: |
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(A) puberty-blocking medication to stop or delay |
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normal puberty; |
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(B) supraphysiologic doses of testosterone to |
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females; or |
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(C) supraphysiologic doses of estrogen to males; |
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and |
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(4) the removal of any otherwise healthy or |
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non-diseased body part or tissue. |
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Sec. 74B.002. CONFLICT OF LAWS. To the extent this chapter |
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conflicts with another law, this chapter prevails. |
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Sec. 74B.003. STRICT LIABILITY FOR HEALTH COVERAGE. A |
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health benefit plan issuer is strictly liable to a patient for the |
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patient's medical, mental health, and pharmaceutical costs, |
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including costs associated with reversing a gender modification |
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procedure or treatment, incurred for the life of the patient as a |
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result of a gender modification procedure or treatment covered by |
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the issuer's plan. |
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Sec. 74B.004. LIABILITY FOR PHYSICIAN OR HEALTH CARE |
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PROVIDER. A physician or health care provider who provides a gender |
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modification procedure or treatment to a patient is: |
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(1) liable to the patient for a malpractice claim in |
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the provision of the procedure or treatment; and |
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(2) strictly liable to the patient for the patient's |
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medical, mental health, and pharmaceutical costs, including costs |
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associated with reversing a gender modification procedure or |
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treatment, incurred for the life of the patient as a result of the |
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procedure or treatment. |
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Sec. 74B.005. EXCEPTIONS. Sections 74B.003 and 74B.004 do |
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not apply to the provision by a physician or health care provider, |
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with the consent of a child's parent or legal guardian, if |
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applicable, and the coverage by a health benefit plan of |
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appropriate and medically necessary gender modification procedures |
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or treatments to a patient who: |
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(1) is born with a medically verifiable genetic |
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disorder of sex development, including: |
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(A) 46,XX chromosomes with virilization; |
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(B) 46,XY chromosomes with undervirilization; or |
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(C) both ovarian and testicular tissue; or |
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(2) does not have the normal sex chromosome structure |
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for male or female as determined by a physician through genetic |
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testing. |
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SECTION 3. Subtitle F, Title 10, Government Code, is |
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amended by adding Chapter 2273A to read as follows: |
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CHAPTER 2273A. PROHIBITED USES OF PUBLIC MONEY |
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Sec. 2273A.001. DEFINITIONS. In this chapter: |
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(1) "Gender modification procedure or treatment" has |
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the meaning assigned by Section 74B.001, Civil Practice and |
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Remedies Code. |
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(2) "Governmental entity" means this state, a state |
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agency, or a political subdivision. |
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Sec. 2273A.002. USE FOR GENDER MODIFICATION PROCEDURE OR |
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TREATMENT. A governmental entity may not use or provide public |
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money for the provision or administration of a gender modification |
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procedure or treatment. |
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SECTION 4. Subtitle E, Title 8, Insurance Code, is amended |
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by adding Chapter 1372 to read as follows: |
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CHAPTER 1372. PROHIBITED COVERAGE OF GENDER MODIFICATION |
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PROCEDURES AND TREATMENTS |
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Sec. 1372.001. DEFINITION. In this chapter, "gender |
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modification procedure or treatment" has the meaning assigned by |
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Section 74B.001, Civil Practice and Remedies Code. |
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Sec. 1372.002. APPLICABILITY OF CHAPTER. Notwithstanding |
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any other law, this chapter applies only 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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(4) a plan providing basic coverage under Chapter |
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1601; |
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(5) the state Medicaid program, including the Medicaid |
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managed care program operated under Chapter 533, Government Code; |
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and |
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(6) the child health plan program under Chapter 62, |
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Health and Safety Code. |
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Sec. 1372.003. PROHIBITED COVERAGE; EXCEPTION. (a) A |
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health benefit plan may not provide coverage for a gender |
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modification procedure or treatment. |
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(b) This section does not apply to the coverage by a health |
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benefit plan of appropriate and medically necessary gender |
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modification procedures or treatments to a patient who: |
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(1) is born with a medically verifiable genetic |
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disorder of sex development, including: |
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(A) 46,XX chromosomes with virilization; |
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(B) 46,XY chromosomes with undervirilization; or |
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(C) both ovarian and testicular tissue; or |
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(2) does not have the normal sex chromosome structure |
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for male or female as determined by a physician through genetic |
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testing. |
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SECTION 5. (a) Chapter 74B, Civil Practice and Remedies |
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Code, as added by this Act, applies only to a cause of action that |
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accrues on or after the effective date of this Act. |
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(b) The changes in law made by this Act apply only to a |
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health benefit plan delivered, issued for delivery, or renewed on |
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or after the effective date of this Act. |
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SECTION 6. This Act takes effect September 1, 2023. |