ADDENDUM
(THIRTY-SECOND DAY — Tuesday, April 29, 2025)
The following remarks regarding CSSB 31 on second and third reading were ordered reduced to writing and printed in the Senate Journal.
(Remarks on second reading)
President: Senator Hughes, you are recognized on Committee Substitute for Senate Bill 31, suspend the regular order of business.
Senator Hughes: Thank you, Mr. President. I move to suspend the regular order of business to take up and consider at this time Senate Bill 31. Senators, the Life of the Mother Act, many Members of this body are co-authors or joint authors on this bill and it's a subject matter that we're, we're all too familiar with. As difficult and as divisive as right to life, as abortion issues can be for us, for all Americans, for all Texans, one thing that I think we all agree on is that the life of the mother must be protected. In those rare situations where the life of the mother is at risk, in those situations, Texas—
President: Members, can we have a little quiet on the floor and off the floor, please? Thank you, continue.
Senator Hughes: Thank you, Mr. President. In those rare situations when the life of the mother is at risk, when she's in jeopardy, Texas law has always recognized that exception. Recently, after the heartbeat law, after Roe—
President: Excuse me. Senator Middleton, Senator West, can you please get out of the way of this presentation. Thank you.
Senator Hughes: Thank you, Mr. President. In the last few years, after the heartbeat law and after Roe v. Wade, when physicians and hospitals were presented with this situation more frequently, questions began to arise. Now, what do we know? We do know, based on abortion reporting statutes, that since the heartbeat law there have been a 150-plus cases where a doctor performed an abortion to save the life of the mother. And those were tragic situations, we don't want to gloss over that. A mom wants to have a baby, she's pregnant, and then there's a complication, her life is at risk. And there are over 150 cases we know about since the heartbeat law where the physician in that case does do an abortion to save the life of the mother. So, that tells us that in most cases, in most cases, doctors and hospitals are following the law, and moms in those hard situations are being treated. We also know from witnesses that have testified before committees in the House and Senate, from folks we have heard from, and from reports in the media, we know there are cases where moms facing situations where they should be treated have been denied treatment. We've read about cases where a mother is dealing with an ectopic pregnancy. Now, everybody in this body knows that the definition of abortion in Texas specifically excludes ectopic pregnancies, and that has been in the code for decades. So, this is something that doctors, we thought, understood. But Section 245 of the Health and Safety Code, the definition says, removal of an ectopic pregnancy is not an abortion. So, no prolife law has any effect, nothing there should keep a doctor from treating an ectopic pregnancy. Dr. Campbell's told us about this from her own, as a physician, and the things that she sees. And so, sadly, we've read about some cases where doctors refuse to treat ectopic pregnancies, or miscarriages. There have been a couple of tragic cases we've read about where a mom was miscarrying, and clearly under Texas law her life was at risk. She should have been treated and she was not. So, because of cases like that, we all thought it important that the law be crystal clear. We don't want to have any reason for hesitation, and we want to make sure that doctors are trained on what the law is. So, the bill before you goes through the abortion statutes in Texas, and it completely harmonizes the language that describes the medical emergency exception. It'll be consistent in every statute so there's no question. And, more importantly, the heart of the bill is the requirement of training so that every physician that deals with obstetrics, every physician whose practice may come into those areas, must receive this training on condition of receiving or renewing a medical license. And because sometimes we know, it's lawyers, maybe hypercautious lawyers, or lawyers for whatever reason, sometimes it's the lawyers not letting the doctors do the care that the standard of care would require. There's also training for lawyers in this bill. A lot of details in Senate Bill 31 I'd be pleased to go through, but those are the broad concepts which you're familiar with. And so, with that, thanking everyone for their work on this bill as we move forward, I move suspension of the regular order.
President: Thank you. Senator Alvarado, what purpose?
Senator Alvarado: To ask the author some questions.
President: Do you yield?
Senator Hughes: Of course, I'll yield, Mr. President.
Senator Alvarado: Senator Hughes, thank you very much for engaging our office, and I know Senator Johnson's office and many others have been involved in this. I see some of my colleagues from the House here, certainly want to thank Representatives Howard and Johnson, and I believe Geren is also here. Senator Hughes, you might know that clarifying the medical emergency exception has been a priority, not only for me but many in this Chamber and in the House. I prefiled bills in 2023 and this session on this exact issue. Even before Roe was overturned, many of us talked about the medical community's concern, about the potential uncertainty created by the language in the bills that were ultimately passed in 2021, particularly in light of the severe criminal penalties for medical providers. Now, I could stand up here and give a big old I told you so speech, but I won't. I wish we had addressed those concerns then and prevented some of the tragedies that have come to light over the last few years, but here we are now and I'm glad that we're addressing this. I'd like to walk through some of the provisions in the bill with you to make sure that the public understands what this bill is. The first is the updated medical emergency definition. This bill makes it clear that a medical emergency is when a woman has a life-threatening condition that places her life at risk or could cause substantial impairment to a major bodily function. It defines life-threatening as capable of causing death or potentially fatal and specifies the life-threatening physical condition does not have to be actively injuring the pregnant woman. Is that correct?
Senator Hughes: Senator, that's right. And that imminence requirement is very important because under the way the law was drafted before. It, and as you know the life, the medical emergency exception language that we used in the heartbeat law in 2021, we incorporated the existing statute, been on the books since 2011, so as not to create confusion. But nevertheless, in the last couple of years some doctors, some, really hospital lawyers, I think, read that language to say that they had to wait. So, a mom's already got a dangerous condition which we know is going to have really bad effects. But a few hospitals were taking the position we have to wait until she gets really bad, even though we know she's going to, before we treat her. And, of course, that was never the intent. So, yes, Ma'am, you are right, that clarification you just read is so important. The medical board addressed this, so did the Supreme Court. We want to put it in statute so there's no question. So, yes, Ma'am, that's so important.
Senator Alvarado: Senator Hughes, in many of the situations that have been reported recently, treatment was denied to women until they were suffering from sepsis and potentially irreversible damage to their organs. To address these types of situations, this bill codifies the Texas Supreme Court's recent decisions in the Cox and Zurawski cases, that the risk of death does not need to be imminent, and it makes it clear that a physician does not need to wait to treat a pregnant woman until she is physically suffering or harmed. Would you say that's correct?
Senator Hughes: Senator, that's right. If a mom has that condition and the docs can see where it's going, they don't have to wait until the mom gets even worse before they treat her. That's exactly right.
Senator Alvarado: Senator Hughes, during the committee hearing, a number of witnesses testified, including some of the plaintiffs in the Zurawski case. They raised serious concerns that some of the changes made by the bill would allow the state to prosecute a woman who obtained or tried to obtain an abortion. However, as you know, the courts going back to 1880, have held that women cannot be prosecuted in the situation. You and I had many discussions over the last several weeks, we discussed it, and now the bill has language to ensure that women cannot be prosecuted. Would you say that's correct?
Senator Hughes: Senator, that's right. You look at what sometimes is referred to as the 1925 statute, which even goes beyond that. And as you know, we've looked at every case, going all the way back to statehood, and moms have never been prosecuted under Texas pro-life laws, and that's clear. It's always been the law and that's reaffirmed here. You're exactly right.
Senator Alvarado: Thank you. And for those listening in, in case you're wondering, that is in Section 20 of the bill. Another concern raised at the hearing is that some of the changes made in this bill would also impact ongoing federal litigation on whether the pre-Roe statutes or the 1925 law, as you mentioned has been referred to recently, are in effect. You've added language to this bill that by amending the medical emergency exception in the 1925 law, the bill does not affect whether the provisions of the 1925 law are reviewed or remain, or have become good law, and will leave it in the hands of the courts. Would you say that's correct?
Senator Hughes: Senator, that's exactly right. Back in 2021, the Legislature did pass legislation that says those pre-Roe statutes are still in effect, they are still there. So, the Legislature spoke to that and that's in front of the Fifth Circuit right now. So, as you say, we're going to leave that to the Fifth Circuit to decide because the Legislature has already spoken to that. Senate Bill 31 does not get into that discussion at all because that's already been held by the Legislature. You're correct.
Senator Alvarado: Okay. And I appreciate your willingness to address these concerns. It was kind of a moving target there for a while.
Senator Hughes: Yes.
Senator Alvarado: Let me talk about what's not in the bill. Okay? Are you familiar with the names of Lauren Hall, Samantha Casiano, Dr. Austin Dennard, Lauren Van Vleet, or D. Ellen, Aylen, sorry.
Senator Hughes: I have seen some of those names. Yes, Senator.
Senator Alvarado: Well, one of the difficult parts of preparing for this bill was reading about some of their stories. These women are all plaintiffs in the Zurawski case who had pregnancies where their fetus was diagnosed with anencephaly, a condition which prevents a fetus from developing a skull, and there's no chance of survival. Would your bill allow women in similar situations where there's a lethal anomaly to get treatment in Texas under the medical emergency exception?
Senator Hughes: Senator, Senate Bill 31 is about the life of the mother and the risks to the mother's life, and it does not address that important topic you raised.
Senator Alvarado: Let's say, they do not have the resources or travel out of state, then they would have to continue, continue their pregnancy like Samantha Casiano, like she did, to carry a pregnancy for months, knowing her child would not survive. Your bill does not make an exception for rape or incest, is that right?
Senator Hughes: Senator, that's right. This bill is about the life of the mother exception, to make sure that the law is crystal clear and to make sure that doctors and hospitals know what the law is, and that's what this bill addresses.
Senator Alvarado: Yeah. You know that that's a real hard pill to swallow, that there's not an exception for rape or incest. I hope one of these days this body finds it in their heart to allow that exception. This bill is a good step forward, wish we didn't have to have this conversation at all in the first place. I believe this bill will save lives, which is why I support it, not only supporting it but co-sponsor with you. I hope that we can come back and do the same for women who are dealing with devastating fetal anomalies, and women and girls who've survived the horror of rape or incest. Y'all, Texas women deserve better. Thank you. Thank you for answering my questions.
Senator Hughes: And thank you, Senator Alvarado.
President: Senator Hall, what purpose?
Senator Hall: Ask a couple of questions.
President: Do you yield?
Senator Hughes: Of course, I'll yield.
Senator Hall: Thank you, Senator. And thank you, Senator Alvarado, for some of your clarifications that as we recall in the hearing we had, the number of women that showed up and described what they had experienced. I am glad that we're now all going to accept the fact that we now have a bill that makes it crystal clear what the doctors can do, because every one of those women that showed up there should have been treated by the doctors. And it was obvious that the doctors chose not to treat them, and it was clear that their intent was to try to take that action to overturn the law we had passed. And it's a shame, it's an absolute shame, as active as our Texas Medical Board is in going after doctors who give patients ivermectin or hydroxychloroquine, couldn't find it, that medical malpractice that every one of those doctors demonstrated with every one of those women, did not step in and do something, because they chose not to treat those women when they could have and should have under the law as it was written. Do you agree with that?
Senator Hughes: Senator, that's right. It was so hard to listen to that testimony. And, of course, none of us have seen the medical records, but in a lot of the testimony we heard, it sounded like medical malpractice, it sounded like doctors not following the standard of care. And I'm glad you raised this point because this bill is a result of a lot of work, not just by the pro-life community, Human Coalition, Texas Right to Life, Conference of Catholic Bishops, Texas Alliance for Life, Texans for Life Coalition, many groups worked on the draft. And at the hearing, groups like ADF had contributions, my goodness, groups like Texas Values had some contributions that led to this version. All that to say, this is about coming together also with the medical community because you remember, Senator, the Texas Hospital Association came in support of this bill, the Texas Medical Association came in support of this bill. And the agreement is, this bill passes and the hospital association, the medical association, all of these groups are going to, with one voice, tell the medical community and moms and everyone else, here's the law in Texas, it's clear, let's follow the law. You're exactly right.
Senator Hall: And you agree that the intent of this is to make sure that never happens again, what we had happen to those poor women where those doctors chose not to do what they could legally do, when they could do it, to try to push forward their personal agenda.
Senator Hughes: Senator, yes, Senator.
Senator Hall: And I do hope our Texas Medical Board is listening to what's being said here and that they will do their job if that should ever happen again, and that those doctors would be treated the way you would treat any doctor that purposefully perform, has malpractice in repeating what they had done because I think this discussion makes it perfectly clear the circumstances in which they can perform medical services for those women. And there's no excuse, zero, now for any women to ever suffer the way they did because of the malpractice of those doctors.
Senator Hughes: Senator, that's right, that's important. That's the essence of this bill. That's right.
Senator Hall: Thank you, Senator.
Senator Hughes: Thank you, Senator.
President: Senator Eckhardt, what purpose?
Senator Eckhardt: To ask questions of the author.
President: Do you yield?
Senator Hughes: Of course, I'll yield, Mr. President.
Senator Eckhardt: Thank you so much, Senator Hughes, I really appreciate it. And I appreciate the committee substitute on this bill, but I do have some questions.
Senator Hughes: Of course.
Senator Eckhardt: First, have you watched the Zurawski v. Texas documentary?
Senator Hughes: I have not.
Senator Eckhardt: Can you tell me what your decision was, what your thoughts were with regard to your decision not to repeal the 1925 portion of the Vernon's code?
Senator Hughes: Well, Senator, in 2021, the House and Senate passed legislation signed by the Governor which held, which affirmed, the Legislature found, a finding is the proper legal term, the Legislature found that those pre-Roe statutes were still in existence and, Senator, you're a very sharp lawyer, but often we'll say a court struck down that statute. But, of course, we realize that a court, even the highest court in the land, has no authority to strike something from a statute. All the court can do is issue an injunction saying this law cannot be enforced. All that to say, Roe v. Wade in 1973 enjoined enforcement of Texas pro-life laws, but they remained there and Legislative Council will confirm to us that those statutes are still on the books, quote, unquote, still in the code. And so, when Roe v. Wade went away, those statutes were no longer enjoined. So, sorry for the long answer, but you know what I'm talking about. In 2021, the Legislature made a finding that those laws are still in effect, and we believe the Fifth Circuit is going to rule on that. But in this bill, in Senate Bill 31, the Legislature, having addressed that, we didn't step into that debate at all, if that's what you're talking about. I hope that answers your question.
Senator Eckhardt: I believe it does, in a way. You agree, it sounds like, that only the Legislature can explicitly abrogate a section of code, that only this Legislature can actually get rid of the 1925 portion of Vernon's code. Correct?
Senator Hughes: Senator, I believe that's right. There's a Fifth Circuit case from some years back which held, I'm not sure if it was indicative or the holding, but this case indicated that those statutes had been repealed by implication. But with deep respect to the court, I believe that's wrongly decided, and I believe the Fifth Circuit will rule differently when it's before them.
Senator Eckhardt: So, as the author of this bill, you have made the conscious choice not to use, not to repeal the 1925 portion of the Vernon's code. Correct?
Senator Hughes: Well, that, of course, that would take a vote of both houses and the Governor's signature, but yes, you're correct, in this bill, this bill does not seek to repeal those pre-Roe statutes. That's definitely correct.
Senator Eckhardt: Although under your committee substitute, this bill does explicitly say that irrespective of those old statutes, a woman, a pregnant woman will not be prosecuted. You have chosen to put that in the bill.
Senator Hughes: Clearly and unequivocally. That's right, Senator.
Senator Eckhardt: And I deeply appreciate that. Also, in Section 8, you have included a list of circumstances that shall not be considered aiding and abetting.
Senator Hughes: Yes, Senator.
Senator Eckhardt: And that list is a non-exclusive list or an exclusive list?
Senator Hughes: Senator, let me look at the specific language. The language is, the language is specific and in its context, I believe it covers the type of speech, the type of conduct that's addressed. And so, I'm curious to see how you read it, but the following activities do not constitute aiding or abetting under this subchapter. There is a specific list there. So, that would be the list.
Senator Eckhardt: So, you do not believe that there are any other circumstances that should be excluded from aiding and abetting?
Senator Hughes: Senator, the intent of this bill is to exclude only these listed.
Senator Eckhardt: So, those specific circumstances listed in Section 8 and the explicit prohibition on prosecuting the pregnant person, other than those, everyone else who is open to criminal or civil prosecution under any existing law is still vulnerable to civil or criminal prosecution under existing law?
Senator Hughes: Senator, that's correct. Whatever the law was today before this bill passes, those situations you're describing are not affected by Senate Bill 31. Other legislation this session could amend those codes further, but on this bill I believe you're correct.
Senator Eckhardt: Now, also in Section 9, page 4, lines 14 through 18, that section requires that the death of the fetus be accidental or unintentional. Do you believe that that section will increase C-sections to potentially save a probably doomed fetus?
Senator Hughes: Senator, I want to make sure I'm in the right place, forgive me, we're on page 4, is that—
Senator Eckhardt: I believe it's page 4, lines 14 through 18, this is in an exception to the application of each law described by Subsection 8, the death or injury of an unborn child resulted from treatment provided to a pregnant female based on a physician's reasonable medical judgment if the death of or injury to the unborn child was accidental or unintentional.
Senator Hughes: Well, Senator, that's abortion, of course, is using means to intentionally take the life of the unborn child. And so, that language restates that if there is not an intentional act of taking life of the unborn child then that would not be an abortion.
Senator Eckhardt: If a doctor is trying to save the life of a patient and they know that the procedures that they are deploying to save the life of the patient are also going to cause the death of the unborn child, is that accidental or unintentional?
Senator Hughes: Well, Senator, forgive me, if, are we talking about a situation where, for, and if I'm wrong, you tell me, are we talking about that situation where a pregnant mother may be diagnosed with cancer and may need aggressive cancer treatments? And so, the doctors, in some cases, will say this cancer treatment that the mom needs, this could, this could harm or kill the unborn child, I want to make sure, is that the situation we're referring to? I want to make sure I'm in, because that is addressed in the bill.
Senator Eckhardt: Yes, it is. Whether it's cancer or some other serious illness like renal failure or some other circumstance that is clearly life-threatening.
Senator Hughes: Thank you, Senator. The language in the bill is to make sure that that is not, if treatment is given to a mom and it's not given with the intent of taking the life of the unborn child, that's not an abortion. So, if that's helpful, I think we're talking about the same thing.
Senator Eckhardt: And I deeply appreciate that. I just wanted to get the legislative intent on the record, that even if the doctor knows that the treatment to save their patient's life will cause the death of the fetus, that is not considered intentional.
Senator Hughes: Because it's the life of the mother. You're exactly right. Yes, Ma'am.
Senator Eckhardt: I wanted to make sure of that. And in that circumstance, does the patient have the right to explicitly choose treatment or an abortion if the situation qualifies as that kind of medical emergency, or is that entirely the physician's decision?
Senator Hughes: Senator, in that situation, of course, the patient would decide whether to receive the treatment for cancer to save the mom and decide whether to, whether to receive the treatment to save her life, which could harm the unborn child, that would obviously be the mom's decision. I don't think the bill speaks to, I'm not sure if I understand, I'm sorry, I'm not sure I'm understanding the question. The mom would decide whether she wanted the cancer treatment at the risk of the child, that would be the mom's decision of course.
Senator Eckhardt: So, in a DNR circumstance, if the patient, the pregnant patient, is likely to become unconscious at some point, can they have a DNR that instructs the physician on which life to save, hers or the fetus?
Senator Hughes: Senator, that situation is not expressly provided for in the bill or any other Texas abortion laws that I'm familiar with, that's not specifically provided for in this bill. But again—
Senator Eckhardt: I agree with you, I just wanted to make sure. I'm also curious about Section 10, the allowance for excepted abortions in certain places. In Section 10, an excepted abortion can occur outside of a hospital circumstance, but only if it is an unlicensed facility that is not also prohibited from receiving state funds.
Senator Hughes: Senator, that's right. So, to walk through the exceptions, what that provision is intended is to say, in a situation where a pregnant mom is experiencing a medical emergency or her life is in jeopardy and there is not a hospital within reasonable distance for her to receive care, she, the medical emergency can be treated elsewhere but not at an abortion clinic. So, this is not for the setting of an abortion clinic, but it does say that if the mom needs help, it does not have to be in a hospital if that's not practical. The mom's life is paramount.
Senator Eckhardt: So, it can occur at a birthing center, for instance?
Senator Hughes: That's right. That's what this language is about.
Senator Eckhardt: Can it occur at home, in a home birth circumstance?
Senator Hughes: Senator, and that would, and that would not be an individual entity to which funds appropriated by the Legislature in general appropriations is actually prohibited from being distributed. That would not be affected by this. Yes, Ma'am, it can.
Senator Eckhardt: But it could not occur at a Planned Parenthood facility?
Senator Hughes: That's correct.
Senator Eckhardt: Do you believe this bill will reduce or increase infant deaths?
Senator Hughes: Obviously the focus is on, for this bill, is on the life of the mother, but if the moms are getting care, Senator, I don't believe this bill will directly affect infant deaths, and if I'm missing something, please help me.
Senator Eckhardt: Only, there's concern, understandably, I would think, that between 2021 and 2022, year over year, there was a 13 percent increase in infant mortality in Texas.
Senator Hughes: Well, Senator, if, broadly, and I think what I'm about to say is logical if we think about the numbers, if more live births are taking place, if there are fewer abortions and therefore more live births, then whatever the, whatever the rate or whatever, whatever was happening with the number of live births we had before, if there are more live births, there will be more complications, more, even infant mortality because there are more births. Those little babies aren't being aborted, the births are taking place, so if the number of births goes up, the number of everything else rises with that. If that's what you're talking about, I don't think that's affected by this bill, but please help me if I got that wrong.
Senator Eckhardt: Well, I'm asking you whether you think this bill, and it sounds like you do think that this bill will result in more live births, and therefore a higher percentage of those live births with, you know, structural abnormalities, and fatal abnormalities, in all, in certain circumstances.
Senator Hughes: Well, Senator, and I was, I was probably imprecise. When I talked about the law resulting in more births, I was referring to the heartbeat law in 2021, which led to more births, and of course the overturning of Roe v. Wade which led to more births. So, that was the, forgive me, those were the numbers I was talking about. Senate Bill 31, of course, is about the life of the mother and protection of the moms in medical emergencies.
Senator Eckhardt: Yes, and I recognize, I think we will agree that this bill is neutral with regard to fatal fetal anomalies, rape, and incest, those are already not an exception under Senate Bill, your Senate Bill 8.
Senator Hughes: That's right. That's correct, Senator.
Senator Eckhardt: And so, I suppose what you are suggesting is since they're already not exceptions under your Senate Bill 8, that now your Senate Bill 31 will not increase live birth of fatal structural anomalies, that it was actually your Senate Bill 8 that did that.
Senator Hughes: Well, if all births increase, then all births will increase, and so across the board the rate is not affected but the raw numbers are. More babies being born, we generally agree that's a good thing, but when the numbers go up, all the numbers go up.
Senator Eckhardt: Thank you for answering my questions. I appreciate it.
Senator Hughes: Thank you, Senator Eckhardt.
President: Senator Gutierrez, for what purpose?
Senator Gutierrez: Will the gentleman yield for a few questions?
President: Do you yield?
Senator Hughes: Of course, I'll yield.
Senator Gutierrez: Thank you, Mr. President. Thank you, Senator.
Senator Hughes: Course.
Senator Gutierrez: This is always a difficult bill to discuss for all of us. It's a difficult bill. You and I, to state the obvious, we're not women. I imagine for the women in this room it's probably even more difficult. For me as a father of two girls, it gets very difficult. You know life comes along and you marry a woman and then you start having family and you have two beautiful daughters, and you never think that these kinds of things are going to make a difference. And so far, thank goodness, they haven't in my life, but I always wonder. And so, every time when these bills come up, I think about my two daughters and it gets difficult for me to remain calm, and I'm going to try to do that. I apologize, too, in advance, if I get too overstrident here and I'm going to try not to. So, under 31, if this pregnancy doesn't create a greater risk of death to the mother or substantial impairment of a major bodily function, then the abortion would be illegal. Correct?
Senator Hughes: That's right. This bill only affects those cases where there's a medical emergency where the mom's life's in danger.
Senator Gutierrez: And these questions have been asked before, and they need to be asked again because of the importance of this bill. And it's true, even if the woman is pregnant from a sexual assault, we just heard you say, that would still be an illegal abortion.
Senator Hughes: Yeah, this bill doesn't address that at all. This bill's about medical emergencies where the mom's in jeopardy.
Senator Gutierrez: And if that child, God forbid, that young woman had been raped by a father or a sibling or an uncle or a grandfather, you know how prevalent incest is? I never realized that until I started looking at this today.
Senator Hughes: It, I'll defer to you if you know the—
Senator Gutierrez: About 15—
Senator Hughes: —numbers.
Senator Gutierrez: —percent of the young ladies out there that are children are subject to some kind of incest. And two percent of those are actually intercourse that leads to, you know, a child being born. So, it's true if a woman's pregnancy is a result of incest, if that young woman, that abortion would be illegal as well.
Senator Hughes: This bill would come into play if the mom is in jeopardy. If her health's in jeopardy or her life's at risk, this bill would come into play. That's the only thing this bill addresses.
Senator Gutierrez: And I understand that there's disagreement that came about between your side of the aisle and doctors and hospitals, and so on, nurses and whatever. But I imagine you've polled your own constituents on this, and I imagine when I see these polls come out, when I see rape and incest come up, people do realize that that's a legitimate exception. And so, why aren't we doing that here today? Why isn't there an amendment or why isn't that part of this bill?
Senator Hughes: And, Senator, I haven't done polling, but I know from speaking to people back home and people here that the life of the mother is an exception we can truly all agree on, and that's what this bill's about.
Senator Gutierrez: I get that that's what it's about but every poll I've read says that Republicans see that rape and incest that results in pregnancy should be an exception and an allowance to be able to go have an abortion. I'm just wondering why we're not doing that important exception here.
Senator Hughes: Senator, this bill is about medical emergencies and about the life of the mother. It's called the Life of the Mother Act.
Senator Gutierrez: If a teenager is impregnated by her stepfather, and there are no medical risks, can she seek an abortion?
Senator Hughes: This bill doesn't address that situation. It's a horrible, unspeakable situation and, Senator, I bet you, like we, have heard testimony from rape victims, even from people who tell us that they were conceived in rape, horrible, unspeakable situations. And there are, we listen to all those witnesses. We try to take all of that in. This bill is about when the life of the mother is in danger.
Senator Gutierrez: And I understand that. And I'm saying that you can amend this bill. The journal, the JAMA Internal Medicine, the American Journal of Medical Sciences out there estimated that during 16 months after this ban took effect, Texas experienced approximately 26,000 rape-related pregnancies. How do we allow that happen as legislators? You know, if a child, if my child said, Daddy, I was raped, you need to help me. I don't want to have this child. You know what I'd do, Senator? You know what I'd do? I would leave. I would go do whatever I needed to do to save my daughter so she wouldn't have to see that rapist every day for the rest of her life. That's pretty harsh. I would go to some other safe, to some other state, so that my daughter would be able to get beyond that horrible moment. And we have the power to do that here today. And you don't want to do it.
Senator Hughes: Senator, in the course of bills over the years, testimony in the House, testimony in the Senate, you and I have both heard, folks we've heard from, again, we've heard from moms who've been through these horrible experiences, difficult for you and I to imagine what a rape would be like and in that situation. We've heard from number of moms who've said as horrible as that experience, unspeakable as that experience was, taking the life of the unborn child did not make it better. It did not make the pain go away. We heard from other moms who chose to move forward with the pregnancy and put the little baby up for adoption or for families to raise. There's no good situation after that happens, but, but we've heard from so many moms who've told us this is my little baby and now my grown child or adult child, that life is worth living. We wouldn't want to say it will be better if she had never been born. I know you're not saying that, but we sure don't want to get close to saying that.
Senator Gutierrez: No, I'm—
Senator Hughes: We, we—
Senator Gutierrez: —saying I would—
Senator Hughes: —we wouldn't—
Senator Gutierrez: —do whatever.
Senator Hughes: —we wouldn't punish the little unborn baby because of the horrible act of the rapist. Let's punish the rapist, but we wouldn't take the life of the little unborn child. A horrible situation we could make even worse by taking a life, Senator.
President: Senators, excuse me, Senators. The whole conversation has totally gone way off from where the bill is, not germane to the topic. Again, as I've said before, a suspension is to ask questions of the author about the bill on the floor, not to delve into other issues anytime on the floor. So, if you can, you can continue, Senator Gutierrez, but please keep it to the bill and, Senator, same for you. Keep it to the bill. This is not another debate on other bills.
Senator Hughes: Course.
Senator Gutierrez: Senator, on this one question, on this one issue, I would tell you that I would do whatever I needed to do to safeguard my child. Whatever I needed to do. Not a woman in this room who doesn't know someone who's been raped. And some of them might know people that have been raped and had to carry that child to term and raise that child. And yeah, I understand the value of that child and life and so on. But imagine to looking your rapists in the eye every day, looking in his eyes. Just imagine that. On to some of the legal things that have already been discussed because I really don't understand why in the world we have the pre-1925 laws even around in this thing. Section 16 of SB 31 discusses the pre-1925 laws. Correct?
Senator Hughes: I believe that's right. Let me turn there and make sure I give you the right answer. What, the 1925 law is discussed and, and Senator, you know the reason why because in 2021, the Legislature found that those pre-Roe statutes were still in effect and that's the last time the Legislature spoke on this, and the Fifth Circuit is about to rule on that. If we had not addressed the 1925 statute, if we had not put this defense there, there would be concerns that the 1925 statute could be used and would not have this medical emergency language. But, yes, I, I'm with you now. Please go ahead.
Senator Gutierrez: I have some concerns about it because I think that what we're trying to fix here is countered by the remnants of any part of that pre- those pre-1925 laws. Does SB 31 repeal any portion of the pre-1925 laws?
Senator Hughes: Repeal? No, Sir.
Senator Gutierrez: In fact, SB 31 amends a portion of the laws in Section 14 of this bill. Is that correct?
Senator Hughes: That's correct.
Senator Gutierrez: Just to be clear and for everyone else here, do you believe, this is important, do you believe that a prosecutor could bring a case against a doctor or someone who procures an abortion as an accomplice pursuant to the pre-1925 law?
Senator Hughes: The Legislature made that finding in 2021, signed by the Governor, it's in front of the Fifth Circuit today. The answer is yes.
Senator Gutierrez: The answer is yes you do believe it.
Senator Hughes: I do.
Senator Gutierrez: Okay, so you believe that a prosecutor could bring a case against a doctor or someone who procures an abortion as an accomplice. The answer is yes.
Senator Hughes: The Supreme Court does not have the authority to blot a statute from the books. They can enjoin its enforcement. Once that injunction's lifted, if the statute's not been repealed, and this one's never been repealed, it's still there.
Senator Gutierrez: I don't mean to be a smart aleck, but we're in the Legislature and we can do what?
Senator Hughes: I beg your pardon.
Senator Gutierrez: We can repeal it right here right now, couldn't we?
Senator Hughes: That's right. The Legislature has never repealed and that's why it's still on effect.
Senator Gutierrez: But we can repeal it right now. Is, my point is the pre-1925 laws are counter to what you're trying to do in this fix. This fix, and by the way you could've done last session, didn't do. The fix of, for four years women have died. For four years women have died, and we've done nothing. But the fix that you're now giving us is quite not a fix because we still have elements of the pre-1925 laws that are causing us confusion by our failure to repeal them. Don't we?
Senator Hughes: Senator, this bill is about medical emergencies, and so under this bill, should it pass, the definition and standard for medical emergencies will be the same in every Texas abortion law including the pre-Roe statutes we're talking about.
Senator Gutierrez: Doesn't it cause confusion to have those pre-Roe statutes and this supposed fix?
Senator Hughes: It, there should be no confusion about medical emergencies after this bill passes.
Senator Gutierrez: Because you put on some language in here, it goes on to say that SB 31 does not affirm or object at any provision within Chapter six and a half, Title 71, Vernon Civil Statutes has been revived or remains or has become good law. Why is that necessary to your bill?
Senator Hughes: Senator, you notice on page 4, line 52, where the language is added, due to a medical emergency. That's, of course, the addition to the pre-Roe statute. Medical emergency is defined in Senate Bill 31 so it'll be the same definition under the heartbeat law, the trigger law, under the other, under the, all the pro-life statutes that the Legislature has passed in the last 50 years, the definition will be identical. That eliminates whatever confusion there might have been.
Senator Gutierrez: They, then you believe that the pre-1925 law is still good law.
Senator Hughes: I do. The Legislature found that in 2021, signed by the Governor. The Fifth Circuit, I believe, will rule thus pretty quickly.
Senator Gutierrez: Why do we need it? Why can't we repeal all the language of the pre-1925—
Senator Hughes: Senator, this bill is about the medical emergency exception to abortions.
Senator Gutierrez: If we did the heartbeat law and we are doing what we're doing today, why do we need something that is going to cause more confusion down the road? I just want an answer as to why. You can repeal it right now.
Senator Hughes: Senator, in 2021, the Legislature made a finding that those pre-Roe statutes are still in effect and valid. They are. We can amend them just like we're doing here. We can make whatever changes we wish. The purpose of this bill is to make the medical emergency exception language identical in every statute so there's no question, no excuse.
Senator Gutierrez: As a lawyer, you've heard of the reenactment rule. Correct?
President: Senator Gutierrez, please keep your questions on the bill. Specifically, questions about the bill, please.
Senator Gutierrez: These questions are about the bill, Sir. The bill's replete with the pre-1925 law.
President: I understand. You've made that point. Questions about the bill, not why this deals with that issue, but what the bill does are your questions. I've given you a lot of latitude. I always give all Members lot of latitude. Ask the questions what the bill does. Okay? Thank you.
Senator Gutierrez: Sure. Does SB 31 amend a portion of the old pre-1925 law?
Senator Hughes: It does. It does. It amends it to make sure that there's question about the definition of a medical emergency so that doctors and hospitals won't hesitate in treating moms.
Senator Gutierrez: Are, do you have any fear that some rogue DA would revive the pre-1925 law and go after people that are possibly, quote, unquote, accomplices?
Senator Hughes: Senator, I want to make sure that I, we're talking about the same thing. We're discussing a potential implied act in this bill. And in 2021, the Legislature explicitly found the pre-Roe statutes are in effect. Any prosecutor looking for authority would go there, wouldn't have to determine if by amending the law we had some unintended effect because in 2021 we specifically found those statutes are still in effect.
Senator Gutierrez: Here's my last question. It's your intent to revive, is it your intent to revive the pre-1925 enactments by passing SB 31?
Senator Hughes: SB 31 makes no, has no effect whatever on that.
Senator Gutierrez: Then no further questions, Mr. President.
President: Thank you, Senator. The motion is on suspension. The Secretary will call the, is there any objection? Hearing none, rules are suspended. Chair lays out in second reading Committee Substitute for Senate Bill 31. Secretary read the caption.
Secretary of the Senate: Committee Substitute to Senate Bill 31, relating to exception to otherwise prohibited abortions based on a physician's reasonable medical judgment.
President: Senator, you're recognized passage to engrossment.
Senator Hughes: That's my motion, Mr. President.
President: Any objection? Hearing none, bill passes to engrossment. You're recognized suspend the Constitutional Three-day Rule.
Senator Hughes: That's my motion.
President: Secretary will call the roll.
(Roll call)
President: Thirty-one ayes, no nays, rules are suspended. Chair lays out third reading and final passage Committee Substitute for Senate Bill 31. Secretary read the caption.
Secretary of the Senate: Committee Substitute to Senate Bill 31, relating to exceptions to otherwise prohibited abortions based on a physician's reasonable medical judgment.
(Remarks on third reading)
President: Senator Hughes, thank you for all of your work over a couple of years on this to get language that had universal support from all sides including pro-life groups and bi-partisan support here. So, thank you for your work on this. You're recognized to final passage.
Senator Hughes: Thank you, Mr. President.
President: Secretary, call the roll.
(Roll call)
President: Hold, hold on, hold on. Senator, you want to speak.
Senator Alvarado: I just wanted to make a request that the remarks on this bill be reduced to writing and placed in the Journal.
President: Let me hold on that for a second. Senator Cook, what was your purpose?
Senator Cook: To speak on the bill, Sir.
President: Okay, you're recognized. I will come back to you, Senator Alvarado, for that motion.
Senator Cook: Thank you, Mr. President and thank you, Senator. I think a lot of y'all probably know this one's very personal. I'm a woman who's had an abortion in this state, and it is, it is really tough to sit and talk about it. And I appreciate y'all engaging on it, and I appreciate Senator Hughes' work on this, and it's just hard. It's just hard because it's the folks who are working on this fix are, from my perspective, the folks who have created the problem. And it's been very difficult to experience the problem in such a personal way, not only for myself but for dear friends that have needed abortions, for patients who are pregnant who are struggling and fearful, for physicians and nurses that I practice with who've really struggled. And so, we know reproductive healthcare in this state is really broken, has been for some time. Over the past four years, we've watched women suffer and die, and this bill is the confirmation that we all agree that something is broken in Texas. And I am also grateful. I'm grateful for the way that this bill is going to carve out the medical exceptions that hospitals and doctors are begging for. But it does leave Texans in the worst most devastating situations without recourse. After this bill passes, and I'm voting yes on it, Texans will still not be able to receive an abortion in case of incest, rape, or fatal fetal anomalies. I just want to talk a second about the fatal fetal anomalies. What I heard Senator Hughes say, and it was beautiful, is that some people whose fetus is not viable, whose pregnancy is not viable, will choose to carry it to term and that's what they need, to love the little potential inside of them and to grieve and to do right by their own spirits. Some of us would make a different choice for the exact same reasons. And that's what we want is that choice to grieve and to love and to experience pregnancy in the way that it's just so unique and so personal. So, even with this bill, which I do think will save lives, we are forcing Texas mothers to risk their lives to carry nonviable pregnancies or terminal fetuses all the way to term, potentially having to give birth, and what a tragic metaphor that is, to give birth to death. And in the meantime, we traumatize our healthcare workforce, our physicians, our nurses, my coworkers. And we're talking a lot about these medical exceptions, which is so important, and thank you, again, Senator, and thank you to everyone who's voting for this, but I can tell you in the same way that the body knows, the body knows sometimes when a pregnancy needs to not continue. And the physicians know when we've got to intervene. Your highest self can also know. There are spiritual and emotional reasons to take action not to carry a pregnancy to term. And so, I just want to emphasize that. There are medical reasons, there are emotional reasons, there are spiritual reasons, and in my opinion, truly just a medically sound policy would leave that decision between women and their doctors, of pregnant Texans and their doctors. So, SB 31 is not a full solution, but it is a step to give medical providers clear, consistent, and uniform guidelines. I do also think that this issue belongs on the ballot. And we've seen a lot of support for ballot measures across the United States, even where the leadership that they elect doesn't necessarily support a broad abortion access. But I suspect we know that it's not going on the ballot because people would vote for it. And that's not the intention of this Chamber to open us up to the true spectrum of reproductive healthcare and that Texans need and deserve. But I am voting yes because these clarifications will save lives. I'm just heartbroken that this Legislature refuses to restore abortion care in Texas and that other lives will be lost because of that. But thank you to every single Texan who spoke up. People have shared their hearts, their stories, their tragedies, their pain with us, and that's the reason that we're even able to have this conversation today. I'm just so grateful to the people of Texas who've never given up, who continue to show up to speak up and to fight to restore safe, legal abortion care in Texas. And it's easy to say that it's malpractice and blame physicians, but I admire, Senator, everybody in this Chamber who says we take responsibility for the outcomes of our policies. We don't get mad at people for the way that policies end up really being implemented and playing out in exams rooms. We are taking ownership of this policy and we're working to fix it. And I just want to say a special thank you to the women in this Chamber, to Senator Alvarado, who has done so, so much for Texas women, for me. I really admire all of the work that has gone into making this best possible bill it can be. But thank y'all so much. Thank you, Mr. President.
President: Senator Eckhardt.
Senator Eckhardt: To speak in favor of the bill. This is really difficult to speak on this bill and it's very difficult to vote for it. I am voting for this bill as I sincerely believe, along with all of my Democratic colleagues and I believe, probably all of my Republican colleagues as well, that it is going to save women's lives who find themselves in a medical emergency. But this bill isn't just about abortion. This bill is an acknowledgement of how desperately fragile our personal rights and liberties are. Under the current order, Texans are no longer allowed to make the most fundamental of personal choices without governmental interference, even prosecution. Religious belief, academic inquiry, political expression, even decision over your own body are now the realm of political control. With or without this bill, Texans can no longer decide for themselves whether, when, and with whom to have children. Every pregnancy must be taken to term unless a physician, if you can get to one, makes a determination that your life or your major bodily function is at risk. You cannot make this decision, little lady. You cannot make this decision, but a physician may be able to under this narrow emergency medical exception. If your pregnancy falls outside of this politically determined exception, not medically determined, politically determined, you are a fugitive. If your pregnancy falls outside of this politically determined exception, you are on your own trying to get to a territory that still provides you your right to determine whether, when, and with whom you have children, and anyone who helps you on your way is vulnerable to civil and even criminal prosecution for helping you. The sliver of hope this bill offers is that the dwindling number of Texas obstetrician and gynecologists who will still practice here will refine the circumstances that they find are dangerous to their patients' lives and major bodily functions and that the Texas courts will corroborate these refinements. Texas women will be reliant on Texas doctors and Texas courts. Texas women will not have a say. This bill drives these cases of a medical emergency into the realm of healthcare liability covered by physician insurance and that is good. I want to believe this bill will make things better because it's hard to believe that things could be much worse. I believe that placing more insurable discretion in the hands of doctors responding to medical emergencies will save pregnant patients' lives so I'm voting for this bill, even though it doesn't recognize fetal fatal anomalies, rape, incest, teen pregnancy, the mental health of the patient, but neither does the current law; even though it doesn't include the full scope of never viable ectopic pregnancies, but it's better verbiage than the current law; even though it doesn't remove the threat of prosecution for doctors, nurses, friends, and family under existing state law. And my deepest thanks go to our powerful doctors' and hospitals' lobby for exerting the pressure necessary to get this clarity on medical exceptions. And my deepest thanks to the women who came forward to relive and retell the horrifying medical emergencies that they have faced. It is unfortunate that this bill gives relief to the doctors and does nothing for Texas women. As you yourself said, Senator Hall, who's not here, doctors could always perform abortions under a medical emergency as defined under Senate Bill 8. So, this bill actually doesn't provide greater relief to Texas women. It just provides greater clarity and relief from liability for the physicians to act in the politically defined medical emergency. But that does nothing for Lauren Miller and her trisomy 18 pregnancy. It does nothing for Kaitlyn Kash and the skeletal dysplasia that her fetus had. It does nothing for Dr. Austin Dennard, Samantha Casiano, Lauren Van Vleet, D. Aylen, and Lauren Hall for their pregnancies with anencephaly. It does nothing for Jessica Bernardo, whose in, whose fetus had fetal anasarca. It does nothing for Amy Coronado or Taylor Edwards whose in, whose fetus had enceph-- I'm going to totally mispronounce this, encephalocele. And it does nothing for Kimberly Manzano whose, whose fetus had Limb Body Wall Complex. The narrow window is made clearer by this bill. In the desperate hope that this bill will get desperate women the care they deserve, I will vote for it, but this policy is no less cruel for being made more clear.
President: Senator Hughes to close.
Senator Hughes: Thank you, Mr. President. As this discussion and debate has reminded us, these are difficult matters to grapple with. We can all agree that when the life of the mother is at risk, she should be protected. That's what this bill is about. I thank each Senator and the leadership of the Senate for getting this moving and for all the folks, interest groups, across the spectrum working on this. And with that, I'm proud and humbled to move final passage of the Life of the Mother Act.
President: Secretary will call the roll.
(Roll call)
President: Thirty-one ayes, no nays, for Senate Bill 31. Thank you, Senator, and thank you, Members.
Senator Hughes: Thank you, Mr. President. Thank you, Senators.