Insurance and Reproductive Health

This bill:

• Changes the rules for Medicaid and private health insurance when it comes to medical care that stops people from having children.

  • Medicaid: A government program that pays for doctor visits, medicine, and hospital care for people who don’t make a lot of money.

• Makes Medicaid and health insurance plans pay for these services even if there are no federal funds. 

• Gets rid of old rules on paying for abortion in health insurance plans.

  • Abortion: a medical treatment that ends a pregnancy.

• Clarifies that these services can’t have barriers to getting care, like needing permission from insurance first, which is called prior authorization.

• Gets rid of some other laws that put limits on what insurance companies can pay for.

• Adds a provision allowing Texas Medicaid to pay for medical care that stops people from having children, even if the federal government can’t give money to match what Medicaid gives.

• Gets rid of laws that used to limit Medicaid and insurance companies for medical care that stops people from having children

• If this bill passes, Medicaid has to pay for these treatments:

  • Abortion

  • All pregnancy prevention treatments that the Food and Drug Administration (FDA) has said are safe, including getting items that prevent pregnancy put in and taken out of your body.

    • FDA: A government group that checks food, medicine, and medical treatments to make sure they are safe to use.

  • Treatments that people choose to have to prevent having children, like vasectomies.

    • Vasectomy: A medical treatment for people with testicles, that prevents them from having children.

• These treatments need to follow state and federal laws.

• If this bill passes, Insurance companies can’t ask for:

  • People to pay part of their health costs 

  • Extra checks before saying “yes” to care that people need.

  • Limits or making people wait to pay for things they need.

• If this bill passes, health insurance plans have to pay for the same treatments that Medicaid does, and anything that helps to manage pain and anxiety for care that stops people from having children

• This bill gets rid of past rules, like:

  • Having to buy separate insurance to pay for abortion.

  • Extra payments for abortion

  • Needing people to sign their name to get insurance to pay for an abortion

• If this bill passes, these changes have more power than other rules about insurance that stop these new ones from working.

• If any part of this law needs a “yes” from the federal government, Texas has to ask for paperwork that says this first first.

  • Texas can hold off on putting the law in place until it gets that “yes”.

• Changes to health insurance are only for plans that start or get extended on or after January 1, 2026.