The bill, H.B. No. 1098, aims to expand the coverage and provision of abortion, contraception, and sterilization services under Medicaid and certain health benefit plans in Texas. It amends Section 32.024(e) of the Human Resources Code to specify that the commission may not authorize services unless federal matching funds are available, except as provided by the newly added Section 32.03118. This new section mandates that medical assistance reimbursement must be provided for abortion services, FDA-approved contraception, and voluntary sterilization, regardless of federal funding availability. Additionally, it prohibits cost-sharing requirements, utilization reviews, prior authorization, and any restrictions or delays in coverage for these services.

The bill also revises Chapter 1218 of the Insurance Code, changing its focus to reproductive health services and requiring health benefit plans to cover the same reproductive health services without imposing additional costs or restrictions. It repeals several existing provisions related to elective abortion and establishes that the new requirements will apply to health benefit plans issued or renewed after January 1, 2026. The bill is set to take effect on September 1, 2025, contingent upon any necessary federal waivers or authorizations.

Statutes affected:
Introduced: Human Resources Code 32.024, Insurance Code 1218.001 (Insurance Code 1218, Human Resources Code 32)