89R2436 SCL-D
 
  By: Hall S.B. No. 115
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to civil liability for, governmental health plan coverage
  of, and public funding for gender modification procedures and
  treatments.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The legislature finds that:
               (1)  as evidenced by a 2018 video of a Vanderbilt
  University Medical Center administrator who promoted gender
  modification surgeries as financially beneficial and stated that
  entire clinics are being financed by phalloplasties, the medical
  community has knowledge that many so-called "gender-affirming"
  treatments are not in the best interest of the health of the patient
  but rather are being promoted for the monetary gain the health care
  facilities will receive from providing those treatments; and
               (2)  the medical community has a conflict of interest
  in offering gender modification treatments and procedures because
  those treatments and procedures create lifelong patients as a
  result of required follow-up visits after those treatments and
  procedures.
         SECTION 2.  Title 4, Civil Practice and Remedies Code, is
  amended by adding Chapter 74B to read as follows:
  CHAPTER 74B. LIABILITY FOR GENDER MODIFICATION PROCEDURES AND
  TREATMENTS
         Sec. 74B.001.  DEFINITION. In this chapter, "gender
  modification procedure or treatment" means a health care procedure
  or treatment provided for the purpose of transitioning a patient's
  biological sex, as determined by the patient's sex organs,
  chromosomes, and endogenous profiles, or affirming the patient's
  perception of the patient's sex if that perception is inconsistent
  with the patient's sex.  The term includes:
               (1)  a surgery that sterilizes the patient, including:
                     (A)  castration;
                     (B)  vasectomy;
                     (C)  hysterectomy;
                     (D)  oophorectomy;
                     (E)  metoidioplasty;
                     (F)  orchiectomy;
                     (G)  penectomy;
                     (H)  phalloplasty; and
                     (I)  vaginoplasty;
               (2)  a mastectomy;
               (3)  the prescription, administration, or supply of any
  of the following medications that induce transient or permanent
  infertility:
                     (A)  puberty-blocking medication to stop or delay
  normal puberty;
                     (B)  supraphysiologic doses of testosterone to
  females; or
                     (C)  supraphysiologic doses of estrogen to males;
  and
               (4)  the removal of any otherwise healthy or
  non-diseased body part or tissue.
         Sec. 74B.002.  CONFLICT OF LAWS. To the extent this chapter
  conflicts with another law, this chapter prevails.
         Sec. 74B.003.  STRICT LIABILITY FOR HEALTH COVERAGE. A
  health benefit plan issuer is strictly liable to a patient for the
  patient's medical, mental health, and pharmaceutical costs,
  including costs associated with reversing a gender modification
  procedure or treatment, incurred for the life of the patient as a
  result of a gender modification procedure or treatment covered by
  the issuer's plan.
         Sec. 74B.004.  LIABILITY FOR PHYSICIAN OR HEALTH CARE
  PROVIDER. A physician or health care provider who provides a gender
  modification procedure or treatment to a patient is:
               (1)  liable to the patient for a malpractice claim in
  the provision of the procedure or treatment; and
               (2)  strictly liable to the patient for the patient's
  medical, mental health, and pharmaceutical costs, including costs
  associated with reversing a gender modification procedure or
  treatment, incurred for the life of the patient as a result of the
  procedure or treatment.
         Sec. 74B.005.  EXCEPTIONS.  Sections 74B.003 and 74B.004 do
  not apply to the provision by a physician or health care provider,
  with the consent of a child's parent or legal guardian, if
  applicable, and the coverage by a health benefit plan of
  appropriate and medically necessary gender modification procedures
  or treatments to a patient who:
               (1)  is born with a medically verifiable genetic
  disorder of sex development, including:
                     (A)  46,XX chromosomes with virilization;
                     (B)  46,XY chromosomes with undervirilization; or
                     (C)  both ovarian and testicular tissue; or
               (2)  does not have the normal sex chromosome structure
  for male or female as determined by a physician through genetic
  testing.
         SECTION 3.  Subtitle F, Title 10, Government Code, is
  amended by adding Chapter 2273A to read as follows:
  CHAPTER 2273A. PROHIBITED USES OF PUBLIC MONEY
         Sec. 2273A.001.  DEFINITIONS. In this chapter:
               (1)  "Gender modification procedure or treatment" has
  the meaning assigned by Section 74B.001, Civil Practice and
  Remedies Code.
               (2)  "Governmental entity" means this state, a state
  agency, or a political subdivision.
         Sec. 2273A.002.  USE FOR GENDER MODIFICATION PROCEDURE OR
  TREATMENT. A governmental entity may not use or provide public
  money for the provision or administration of a gender modification
  procedure or treatment.
         SECTION 4.  Subtitle E, Title 8, Insurance Code, is amended
  by adding Chapter 1373 to read as follows:
  CHAPTER 1373. PROHIBITED COVERAGE OF GENDER MODIFICATION
  PROCEDURES AND TREATMENTS
         Sec. 1373.001.  DEFINITION. In this chapter, "gender
  modification procedure or treatment" has the meaning assigned by
  Section 74B.001, Civil Practice and Remedies Code.
         Sec. 1373.002.  APPLICABILITY OF CHAPTER. Notwithstanding
  any other law, this chapter applies only 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;
               (4)  a plan providing basic coverage under Chapter
  1601;
               (5)  the state Medicaid program, including the Medicaid
  managed care program operated under Chapter 540, Government Code;
  and
               (6)  the child health plan program under Chapter 62,
  Health and Safety Code.
         Sec. 1373.003.  PROHIBITED COVERAGE; EXCEPTION. (a) A
  health benefit plan may not provide coverage for a gender
  modification procedure or treatment.
         (b)  This section does not apply to the coverage by a health
  benefit plan of appropriate and medically necessary gender
  modification procedures or treatments to a patient who:
               (1)  is born with a medically verifiable genetic
  disorder of sex development, including:
                     (A)  46,XX chromosomes with virilization;
                     (B)  46,XY chromosomes with undervirilization; or
                     (C)  both ovarian and testicular tissue; or
               (2)  does not have the normal sex chromosome structure
  for male or female as determined by a physician through genetic
  testing.
         SECTION 5.  (a) Chapter 74B, Civil Practice and Remedies
  Code, as added by this Act, applies only to a cause of action that
  accrues on or after the effective date of this Act.
         (b)  The changes in law made by this Act apply only to a
  health benefit plan delivered, issued for delivery, or renewed on
  or after the effective date of this Act.
         SECTION 6.  This Act takes effect September 1, 2025.