The bill, S.B. No. 359, 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 authorizations, and any restrictions or delays in coverage for these services.

The bill also amends the Insurance Code, changing the heading of Chapter 1218 to "Coverage for Reproductive Health Services" and updating definitions related to abortion and pain management. It requires health benefit plans to provide coverage for the same reproductive health services without imposing cost-sharing or other restrictions. Several existing provisions are repealed to streamline the law, and the bill specifies that it will apply to health benefit plans issued or renewed on or after January 1, 2026. The act is set to take effect on September 1, 2025.

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