The Senate Committee on Health & Human Services met on August 8 to take up SB 4 (Lucio) and SB 2 (Perry). Both bills were voted out at the end of the hearing.
This report is intended to give you an overview and highlight of the discussions on the various topics taken up. It is not a verbatim transcript of the discussions but is based upon what was audible or understandable to the observer and the desire to get details out as quickly as possible with few errors or omissions.
Opening Comments
- Kolkhorst – Heard these bills less than 30 days ago, had good testimony; SB 2 had a 9-hour hearing and SB 4 had an hour
- Both of these bills were heard during the regular session in State Affairs, both of these bills passed the Senate, but were not able to be heard in the House
- Hall – We’re going to hear both bills and then do public testimony?
- Yes, will start with SB 4 and then SB 2
SB 4 (Lucio) Relating to abortion complication reporting and the regulation of drug-induced abortion procedures, providers, and facilities; creating a criminal offense.
- Lucio – These drugs were part of the FDA REMS program due to safety concerns, not permitted to be prescribed & delivered through the mail
- Federal government chose not to enforce regulations, SB 4 implements heightened regulations for these drugs
- Many testify to drug safety, but this is due to regulations and doctor oversight; oversight is necessary
- Powell – Is this bill exactly the same bill we heard in State Affairs?
- Lucio – To my knowledge, same bill as in Regular Session and First Special
- Kolkhorst – When we heard this bill last month, we talked about rules promulgated under President Clinton?
- Rules were set up under Clinton administration
- Kolkhorst – Understanding is that the rules change was a COVID protocol, FDA intending to continue this and allow these to continue to be distributed without doctors
- FDA stated they would not be enforcing
- State has right to address the issue if the federal government is not going to enforce something they should
- Bill is trying to ensure there are not two deaths instead of one by involving medical professionals
- Kolkhorst – Also discussed abuse of these drugs by human traffickers
- Hall – Talking about pharmaceutical companies who have not taken much responsibility with human life, we’re now removing safeguards from drugs with abuse & misuse potential
- Hall – State has responsibility when the federal gov has abdicated its responsibility
Jennifer Allmon, Texas Catholic Conference of Bishops – For
- Wanting to ensure mother’s safety in addition to child, bill helps protect those preyed upon by human traffickers and abusive partners
- Important to test for Rh negativity and gestational age due to risk of complication
- Bill also imposes felony penalties, out-of-state physicians can be extradited under this penalty
- FDA has signaled they intend to make change in November 1, need bill to pass quickly in order to implement ahead of this date
Jessica Colon, Susan B. Anthony List – For
- Provides legislative history, similar bills have passed in OK, AK, and MT
- FDA stated they would not insist on doctor’s appointment, doctor oversight is critical to avoid complications; stay in ongoing litigation was granted because FDA intends to act by Nov 1, need to act to untie Texas from this
- Blanco – What options are available for women seeking abortions in rural areas?
- Options don’t change, all we’re asking for is to have doctors see patients in person
- Need to check for Rh negativity and gestational age
- Blanco – Highlights very rural areas without doctors, what options are available?
- Current options available right now, not asking for those to change
Dr. Ingrid Skop, Charlotte Lozier Institute – For
- Have seen many women harmed by drug-based abortions, carries risk of complications
- Requires reporting of abortion complications, US has never required reporting
- Studies by the US abortion industry will say abortion is safe, but international studies show different data with evidence of harm
- No benefit for a woman with these abortions, takes longer, results in complications 4x as frequently
- Also harmful when medical resources must be conserved during pandemic
- Removing REMS restrictions have been a long-term goal of the industry; SB 4 re-establishes supervision and requires informed consent
- Perry – FDA currently has a rule requiring in-person visitation? Because of complication risk
- Removed in April, this was the prior law
- Perry – Know several who were given these drugs as a result of miscarriage, led to complications; is this the fear without a doctor’s visit?
- Correct, many women think this is safer, but not informed that this is 4x as dangerous
- Women in remote areas are in even more danger due to complications
- Perry – Rule is not being removed, FDA is just not enforcing, does this put medical practitioners in sights for lawsuits?
- Possibly, definitely is poor quality medicine
- Perry – Getting into a situation where Amazon would be the pharmacy, prescriptions given without contact with the patient; practice was put into place by Clinton Administration
- Blanco – CDC demonstrates abortions in this category have a 99% safety record with rare serious complications?
- Never mandated complication reporting, many times women do not return, difficult to get an accurate IDC code for ER visits
- CDC is reporting data that has been put together by the abortion providers, publishing studies based on poor data
- Many European countries are reporting different numbers, 5-10% failure
- Blanco – So the CDC’s data is not necessarily accurate?
- Correct, based on incomplete data
- Blanco – Less than 3% of abortion patients require hospitalization for complications?
- Many do not go back, may not report that complications are from abortion
- 6% present with complications, happens frequently
- Blanco – How long have we been using this medication?
- Approved by FDA in the year 2000
- Perry – Is it fair to say that these numbers are from dates prior to April? Numbers from when we had physician oversight?
- Correct, concerned about safety of Texas women
- Perry – No data today to reflect situation without physician oversight, correct?
- Correct FDA studies based on poor data
- Perry – Not requiring physician oversight, data was based on physician oversight
- Correct
SB 2 (Perry) Relating to requiring public school students to compete in interscholastic athletic competitions based on biological sex.
- Perry – Requires sports based on sex assigned at birth
- Highlights that birth certificates can be changed, large percentage increase for requests to change birth certificates; process to obtain court order based on testimony of person with a physician’s letter
- Kolkhorst – Bill as crafted is what is currently in UIL?
- Perry – No, UIL will accept amended birth certificates; bill allows for short amount of time when needed to correct indeterminate sex designation on birth certificate
- Seliger – Any differences between SB 2 and versions in Regular and First Called?
- Exactly like SB 29 in the Regular, UIL only
SB 4 Public Testimony
Amy O’Donnell – Texas Alliance for Life – For
- Supporting SB 4 in case federal gov blocks FDA regulations
- Drug-induced abortions are the second most common type, result in 4x higher complications
- In person visit is essential to determine if there are dangerous conditions
- Kolkhorst – Do people normally know if they’re Rh negative?
- Would imagine there are many women with no idea what their blood type is
Mary Elizabeth Castle, Texas Values – For
- Drug-induced abortions were recommended by providers in lieu of in-person procedures that were blocked during the COVID pandemic
Theresa Maska, Students for Life Action – For
- Women are not informed and cared for with adequate caution with drug-induced abortions; necessary for a doctor to check for safety
Rachel Schrader, Students for Life Action – For
- Important for doctor to check for gestational age, ectopic pregnancy
John Seago, Texas Right to Life – For
- Appreciates persistence of Senate in passing this bill 3 times
- As gestational rate increases, complication rate of drug-induced abortions increases
- Recommends amendment to allow AG’s Office to enforce the penalty and authorizing a private cause of action for those who violate this or other pro-life laws
Blake Rocap, AVOW – Against
- Change in REMS would have no effect on abortions in Texas, every abortion requires in person visitation and sonogram 24 hours ahead of procedure
- Will only change ability of physicians to provide needed care between 7 to 10 weeks, would possibly force rural Texans to stay in clinic for a longer time
- Perry – So under the removal of the REMS enforcement, that women seeking chemical abortions would still have to have sonogram and in person visit?
- Under Texas law, this is correct, would not change
- Perry – Inconsistent with other information
- Certainly is
- Kolkhorst – You used to be NARAL Pro Choice?
- Correct
- Kolkhorst – Why do you think everyone else is wrong?
- Texas regulates medical practice and requires these visits, REMS is not being enforced, but prescription will still be required and physicians will still be required to follow all restrictions in care in the Health & Safety code
- Perry – So states allowing telehealth, this would allow provision of drugs without in person visit
- There are drug-induced abortions in clinics with doctor present via teleconference
- Waiver applied to COVID practice
- Perry – So if a woman was to log in and obtain a doctor via telehealth, they could get the prescription without the in-person visit
- Yes, my understanding is this is how it works in other states and for residents of other states
- Perry – Texas allows for telehealth
- Not for abortion
- Perry – This was the distinction I was looking for; still need to pass this bill to reaffirm commitment to women’s health, need to make clear that Texas statute is not following FDA guidelines
- Bill mostly affects patients in that 7 to 10 week period
- Bill would also subject physicians to felony for failing to report complications from a future pregnancy
- Powell – Are there other consequences of this bill you would like us to be aware of?
- Biggest ones, bill list several complications that are already reported to HHSC
- Campbell – Want to ensure that we don’t allow this medication to be mailed out in any circumstance
- Fair point, remove restriction to 49 days, would still have in person visit, access to medical abortion up to 10 weeks
- Campbell – We’re good where the bill is
- Kolkhorst – Discussion highlights why we need to get FDA out of Texas law, also enhances criminal penalty and strengthens complication reporting
Susana Carranza, League of Women Voters – Against
- Access to safe abortions is a priority issue for the League, women should be allowed to make their own choices regarding fertility
- Without safe and legal abortions, women will resort to much less safe options
- Those who oppose abortion do not have the right to impose religious views on others, SB 4 places restrictions on access to proper care
- Campbell – Are you for the patient having to see the physician before the medication is provided?
- Would ask you to contact the League
- Campbell – Seeing a physician is a safer route, would you agree the patient should see the doctor in their office?
- Not my area of expertise
Parliamentary Inquiry
- Blanco PI – Are SB 2 and SB 4 identical to bills passed out of committee in the First Special
- Lucio – Did you see anything different in either bills? Answer is yes to my knowledge? Did you have access to these bills?
- Blanco – Didn’t see anything different, just point of clarity
- Lucio – Did you read the bills? If you read all three bills, do you see something different? To my knowledge this is the same bill
- Blanco moves to adopt previous testimony for SB 4 and positions for and against
- Kolkhorst – Different session, you can go back and look at it, but don’t have authority to do this
- Blanco – We do have witnesses that are worried about attending due to COVID, and timeline was short for people coming from far away
- Chair Kolkhorst rules that motion is not in order
Closing Comments
- Lucio – Appreciates that Sen. Blanco brings up rural Texas and medical services are not always available, my advice would be to write a bill to provide incentives for doctors and nurses to practice in those areas, but that is not what this bill is about
- Kolkhorst – Will have a floor debate on this, statistics from the other session may be brought up
- Kolkhorst – We do have an aggressive schedule, have a hearing we’re working on for the COVID surge charge, were trying to have this on Tuesday morning, but there are witness conflicts, working to get this scheduled this week
7 for, 18 against registered but not testifying
SB 4 voted out at the end of hearing (5-2)
SB 2 Public Testimony
Jennifer Evans, Save Women’s Sports – For SB 2
- Biological differences lead to male domination of sports, highlights time differences between male and female runners; roughly 300 male high school students have better times than college age female runners
Elizabeth Jordana, Save Women’s Sports – For SB 2
- Males have an unquestionable biological advantage in all cases
Susana Carranza, League of Women Voters – Against SB 2
- League opposes SB 2 and any bill that discriminate against transgender Texans
- Bill is not about protecting sports, but more about pushing vulnerable transgender youth to the sidelines, bill will affect transgender or cisgender girls, any girl could be accused of being a “biological male”
Brad Pritchett, Self – Against SB 2
- LGBTQ members are not participating in this hearing due to hostility against transgender individuals
- Sen. Kolkhorst filed the bathroom bill, Sen. Perry files bills targeting transgender children, Sen. Hall filed bills blocking care
- Committee members obsess over new ways constantly target transgender people, committee members are fundamentally bad people
- Perry – Don’t have anything to say in response to vicious testimony
- Campbell – Many women have testified in defense of sports
- Hall – Agrees with colleagues, bills are filed to protect rights
- Pritchett – Apologize if I hurt your feelings, but more concerned about the wellbeing of transgender children
- Blanco – Does this bill allow for government to out transgender children?
- Bill does transgender children and their families a great deal of harm, respect opinions of witnesses, but does not believe intentions of bill are to protect, intentions are to target children
- SB 2 will cost transgender and nonbinary children their lives
Jade Dickens, Self – For SB 2
- Opening door to male bodies will harm women, IOC will review transgender policy
- Kolkhorst and Dickens discuss Dickens’ powerlifting history, ability of male competitors to enter weightlifting and best female competitors
Don Garner, Texas Faith & Freedom Coalition – For SB 2
- Testifies in support of SB 2, bill protects
Jonathan Covey, Texas Values Action – For SB 2
- Those against say this addresses a problem that doesn’t exist, but there are several examples
Holt Lackey, Equality Texas – Against SB 2
- Opposes SB 2, coalition and partners are boycotting today’s hearing
- Repeated hearings have been held without significant evidence of issues in Texas schools, committee has heard from citizens, parents, educators, etc. and this is on the record
- After summary passage during Frist Special, it became clear that the committee did not care about LGBTQ individuals
- Blanco – Trump appointed federal judge already enjoined a similar ban due to absence of empirical evidence for such a law, that this could lead to targeting girls and pushing them out of sports; what is the need for this bill? What is the impact?
- No need for the bill, will open state’s female women athletes to being challenged
- While SCOTUS has not explicitly tied Bostock opinion to Title IX, language is very similar to Title VII issues
Cassidy Comber, Self – For SB 2
- Supports SB 2, biological differences between men and women can be seen in all sports
Janet Comber, Self – For SB 2
- Bill is critical for preservation of equality in women’s sports, scholarships are rare for female athletes
Ash Hall, Self – Against SB 2
- LGBTQ individuals are boycotting this hearing due to political attacks on personhood of transgender people; last hearing, transgender youth and their parents were treated with disrespect
- No point in speaking to politicians whose hearts and minds are closed to transgender people
- Blanco – Completely understand the boycott, takes a lot of courage to come and represent the community
Allison Mohr Boelware, National Association of Social Workers Texas – Against SB 2
- Highlights negative mental health effects of legislation like SB 2, Trevor Project study has shown negative impacts and should consider these; 75% of children have experienced discrimination based on their identity
- Kolkhorst – Asks for study info
- Trevor Project which works to prevent suicide in the LGBTQ community
- Blanco – Do you see any proposed guidelines in this bill for when, where, or how a student’s gender can be called into question?
- Would be the duty of those around that sport; could be fear at a game that athletes would be open to accusations, could be fear of different treatment; school social workers reported these effects
- Perry – Without this bill there is a process for players to challenge other players; can’t control behavior, but UIL has a process to handle challenges for whatever reason, no one will be asking to see genitals
- Concerned that the rhetoric, conversation can be very ugly and has opened up more opportunities for people to question others
- Hall – People will get upset when given false information and organizations will use this
- Powell – Asks Boelware to discuss negative impact more; testimony throughout these hearings has been painful because of what we’re putting transgender children through
- Hardest testimony to listen to because of the passion on both sides, can be difficult for families to hear comments about their bodies
- Transgender children do have higher rates of depression and suicide, but those with affirming spaces do not see these same statistics; inclusion is what is helpful for mental health
- Campbell – Do you have a study that shows an increase in suicide because transgender children are not playing in sports
- There is information to show legislation in general contributes to suicide rate
- Would be accurate to say that when bills target this community
- Campbell – Bill targets women’s sports, not a target on transgender children
- Kolkhorst – SB 2 is very narrow in what it’s trying to do in protecting traditional women’s sports
- Hasn’t been enough time to study specifically how this bill affects suicide rate, but can speak to how people feel accepted or discriminated against
Kayton Asher, Self – Against SB 2
- Bill would negatively impact foster youth, makes it more difficult for foster care youth to participate
- Legislation opens conversation and more discrimination, this bill does open pathway to other legislation like Sen. Hall’s bill on mental health
- Bills like this would affect health care, many doctors refuse to treat transgender individuals; will probably leave the state very soon, cannot be in a state where life is threatening daily
Lauren Rodriguez, Self – Against SB 2
- Parent of transgender son, was on a coed track team and UIL determined he was not allowed to play on either sports team; son chose to leave state for college
Grayson Rodriguez, Self – Against SB 2
- One of the few people here, most boycotting
- Women’s sports are not in danger, puberty blockers cause physical disadvantages
- Was banned from playing sports altogether after coming out as a trans man at 17, had no options for sports
Gordy Carmona, Self – Against SB 2
- Has been involved in support groups and transgender children have shown large amounts of fear
- Won’t solve issues without reaching out to trans community
Janna Pettijohn, Self – For SB 2
- Supports SB 2, culture of women’s sports under Title IX is important and needs to be protected
- Transgender individuals deserve to play sports and live in society, but cannot be at cost of female rights
4 for, 23 against registered but not testifying
SB 2 voted out at end of hearing (5-2)
Closing Comments
- Kolkhorst – Hearing on hospital capacity & COVID under Gov’s call will happen this week, wanted it on Tuesday, but scheduling conflicts; may be very early morning