By: Hall, et al. S.B. No. 1029     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 1372 to read as follows:   CHAPTER 1372.  PROHIBITED COVERAGE OF GENDER MODIFICATION   PROCEDURES AND TREATMENTS          Sec. 1372.001.  DEFINITION. In this chapter, "gender   modification procedure or treatment" has the meaning assigned by   Section 74B.001, Civil Practice and Remedies Code.          Sec. 1372.002.  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 533, Government Code;   and                (6)  the child health plan program under Chapter 62,   Health and Safety Code.          Sec. 1372.003.  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, 2023.