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 stipulate 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 specifies that these services cannot be subject to cost-sharing requirements, utilization reviews, prior authorizations, or any restrictions on coverage.

The bill also revises the Insurance Code, changing the heading of Chapter 1218 to focus on reproductive health services rather than elective abortion. It requires health benefit plans to cover abortion services, contraception, and sterilization without imposing cost-sharing or other restrictions. Several existing provisions related to elective abortion are repealed, and the bill establishes that the new requirements will apply only to health benefit plans issued or renewed after January 1, 2026. The act 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 (Human Resources Code 32, Insurance Code 1218)