The Texas Senate on Wednesday gave initial approval to a measure that would require women to pay a separate premium if they want their health plan to cover an elective abortion.

Under Senate Bill 20, health plans would still be allowed to cover abortions that are deemed medically necessary. The measure does not make exceptions for cases of rape or incest.

The vote was 19-10. The measure will get a final vote before heading to the House.

"If you go back to the basics of insurance, it's to cover large, unexpected expenses," said the bill's author, state Sen. Larry Taylor, R-Friendswood. "In the case of abortion, you're electing to have that procedure done." 

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The bill is one of a number of abortion restrictions the Senate has approved recently. Earlier this week, the chamber passed Senate Bill 25, which would preventing parents from suing doctors if their baby is born with a birth defect and Senate Bill 415 which would require doctors to make sure a fetus is deceased before performing a certain type of abortion. Last week, Texas senators passed Senate Bill 8, which would  ban what opponents call "partial-birth" abortions and put restrictions on donating fetal tissue.

Critics of SB 20 say Texans should not have to pay for supplemental coverage for abortions. Heather Busby, executive director of NARAL Pro-Choice Texas, said in a news release that the measure jeopardizes Texans' health care options and would have a heavy impact on low-income Texans, people of color and young people.

"Having insurance coverage for abortion is important to ensure that every Texan can access the care they need in a timely manner," Busby said. "It is wrong for the government to place restrictions on private health insurance companies looking to offer a full range of reproductive health services, including abortion."

But Taylor told senators that his legislation would allow women to have their abortion covered while not forcing other policyholders to pay for it. He argued that people who are anti-abortion should not have to pay for abortions if they don’t believe in them.

“This is giving the people who support pro-choice the choice to buy that coverage separately and leave everyone else out of it,” Taylor said.

Taylor said he was inspired to push the measure because of his daughter's recent pregnancy. He recently welcomed a new grandson born with Down syndrome and heart problems. When his daughter found out what her baby's condition would be, he said, she knew she would not have an abortion. Taylor says his daughter's situation is why he believes women know deep down if they would want to keep or terminate a pregnancy.

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But reproductive rights advocates say no one can anticipate needing an abortion and forcing people to pay for it as supplemental coverage is wrong. 

And Sen. Sylvia R. Garcia, D-Houston, told Taylor that the bill "is just trying to tell business what to do with insurance coverage they want to provide."  

Taylor pointed to the 2010 federal health law as part of his reasoning behind the bill. The Affordable Care Act allows states to choose how to regulate abortion coverage. Twenty-five states have opted to ban abortion coverage through health insurance plans, according to a 2016 report from the Kaiser Family Foundation.

Melissa Conway, director of external relations for Texas Right to Life, said in a news release Taylor's bill "would protect the freedom of all Texans to abide by their consciences." 

"Texans deserve the right to decide where their insurance and tax dollars go, and they should not be forced to fund the elective abortions of others," Conway said. "The majority of Texans are pro-life and neither want nor need insurance coverage for elective abortion."

Read related Tribune coverage:

  • Texas senators advanced two anti-abortion bills, one that would prevent parents from suing doctors if their baby is born with a birth defect and another that would require doctors to make sure a fetus is deceased before performing a certain type of abortion.  
  • Texas Democrats and abortion rights advocates are strategizing amid mounting worries over what the GOP-led Legislature and federal lawmakers may do in the coming months to further restrict access to the procedure.
  • Reproductive rights advocates have expressed concern that Texas lawmakers will take bolder steps in the upcoming session to defund abortion providers and dismantle access to abortion, birth control and other sexual health services.

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