SIXTH DAY --- MONDAY, JUNE 24, 2013

[SB 5 was laid before the house.]

REPRESENTATIVE C. TURNER:  What do the House Rules prescribe as the criteria for setting a bill on the major state calendar as opposed to the general state calendar?

SPEAKER STRAUS:  Mr. Turner, under Rule 6, Section 7, a bill on major state is a bill of statewide effect, which establishes or changes state policy in a major field of governmental activity. A bill on the general state calendar is a bill of statewide effect, which establishes or changes state law and have application to all areas but are limited in legal effect by classification or other factors which minimize the impact to something less than major state policy.

C. TURNER:  What calendar were the redistricting bills that we considered last week, what calendar were those bills placed on?

SPEAKER:  I don't recall, Mr. Turner.

C. TURNER:  Okay. If I'm not mistaken, I believe it was the general state calendar---if I'm wrong on that, if the chair could correct me. Mr. Speaker, my inquiry relates to the substance of SB 5 and the fact that it says bills of statewide effect, which will have a major impact and application throughout the state without regard to class, area, or other limiting factors. And, I think, in the second reading of this bill, we heard extensive debates and a lot of facts pointed out that this is a bill that actually does have an effect with regard to class, area, and other limiting factors, given that this is legislation designed to shut off access to certain health care services in certain parts of the state while keeping them available in other very limited parts of the state. And I just wonder if this bill meets the criteria for a major state calendar versus the general calendar where redistricting bills, which obviously impact the whole state without regard to class or area, were placed?

SPEAKER:  Mr. Turner, I'd have to direct you to the members of the Calendars Committee and to Rule 6, Section 25. Mr. Turner, the house calendar for June 20, major state calendar––the three redistricting bills were on the major state calendar.

C. TURNER:  I stand corrected. I beg your pardon, Mr. Speaker. So, the major state calendar necessitates that those bills appear before the constitutional amendment calendar in the regular order of business, is that correct?

SPEAKER:  Yes, Mr. Turner. Under Rule 6, Section 7, major state is under calendar two. The constitutional amendment calendar would be calendar three.

C. TURNER:  Okay. Well, I'd like to then, just for the record to reflect and the members to understand and the public to understand that the Calendars Committee and the leadership of this body placed bills pertaining to abortion, which many would argue are unnecessary, ahead of statewide transportation policy. And I think the record should reflect that fact based on this inquiry. And I'd like to move that this exchange and all exchanges today be reduced to writing and placed in the journal on consideration of this bill.

SPEAKER:  Members, you've heard the motion. Is there any objection? The chair hears none. So ordered.

REPRESENTATIVE S. TURNER:  Representative Laubenberg, this is just some questions in reference to the bill itself and the bills that we have previously passed in other legislative sessions. Do you consider SB 5 to be like an omnibus bill as it relates to abortion?

REPRESENTATIVE LAUBENBERG:  Yes, I do.

S. TURNER:  Okay. And then, with regards to the bills that we have previously passed in other legislative sessions, combined with SB 5, do you see a necessity then for any additional bills on this particular subject, or does this pretty much encapture all the need for any legislation based on what the law is today?

LAUBENBERG:  Okay, I'm sorry, Representative Turner. Are you asking me if this bill covers everything related to abortion?

S. TURNER:  No, let me try to be more clear.

LAUBENBERG:  Okay. And, forgive me with the––

S. TURNER:  No, no, no, that's okay. We have passed previous legislation that relates to abortions. You will agree with me that this, not just in this session, but in previous sessions.

LAUBENBERG:  Yes.

S. TURNER:  SB 5 is viewed as a more omnibus bill. From your vantage point---I may disagree---but from your vantage point, that is significant in enhancing public safety, I guess you would say. Okay. Would that be one way of looking at it?

LAUBENBERG:  Women's health safety, yes.

S. TURNER:  Okay. And my question is, to the extent SB 5 passes––let's say SB 5 passes out of the house finally, SB 5 passes out of the senate when it goes back over there, signed by the governor. Does this represent the final piece of legislation, in your view, on this particular subject matter, or do you foresee the need for additional legislation on this subject?

LAUBENBERG:  Representative Turner, I am delighted with this bill. I will tell you honestly I think this will go a long way to helping women, obviously helping that baby, and protecting women. And my head is a little bit muddled right now with probably no sleep. And so, can I say for everything in the future? I am delighted with what we have now. I never try to predict the future.

S. TURNER:  And, I guess that's the gist of my question; whether or not, based on what is included in SB 5, combined with everything else that we, this legislature has done, is there any area that SB 5 does not cover that you see a need to cover even with the passage of SB 5? And my basic question is, are we at the point where this is it, or are we to anticipate Representative Jodie Laubenberg or someone else on the floor of this house now to put forth––

LAUBENBERG:  I see what you're saying. I know. Will there ever be––

S. TURNER:  Where's the end; where's the finish line? Or is it the goal––

LAUBENBERG:  I think that we've made some really good steps. Do I, you know, I don't have a crystal ball. Can I predict what other members may do in the future? No, I cannot.

S. TURNER:  No, because if the response is the goal, for example, is to eliminate abortions, if that is the goal, and then this is just another step to eliminating abortion––I mean, I certainly will accept that as the answer. So, until abortions are eliminated, we don't get there. So, I'm trying to see from a policymaker, legislative point of view, does this bill do enough?

LAUBENBERG:  I can tell you my view. My view is I would definitely like to see as few abortions as possible. That's my view.

S. TURNER:  And this bill will help you achieve that.

LAUBENBERG:  Definitely. The 20-week preborn pain part of it definitely will, yes.

S. TURNER:  Okay. Now, so am I to conclude, though, that there will continue to be legislation brought before the legislature, the Texas Legislature, until that goal is achieved, and that is the total elimination of abortion?

LAUBENBERG:  I can't––I don't know, I'm sorry. I can't––what I can tell you today may not be the case for someone else in the future.

S. TURNER:  Well, I hope you understand––

LAUBENBERG:  I know, I know, I know you're trying to ask me.

S. TURNER:  Are we through on this subject matter?

LAUBENBERG:  I don't know.

S. TURNER:  You know, that's the question I'm trying to ask is that.

LAUBENBERG:  And I'm not trying to mislead you; I'm honestly trying to say that I don't know.

S. TURNER:  No, I accept your answer, whatever that is, but the point is, from a policymaker, is whether we agree or disagree on the legislation––

LAUBENBERG:  Right, I know.

S. TURNER:  One would like to think that there is a finish line somewhere. And, I guess I'm left to conclude that SB 5 is before us today, but to the extent there's another special, to the extent that there's another regular session, there can be another piece of legislation on the same subject matter coming forward until abortions are eliminated in the State of Texas. Would that be a fair conclusion on my part?

LAUBENBERG:  I have to be real honest with you, I don't know.

S. TURNER:  Okay. But it is your belief that this is a significant step in eliminating abortions?

LAUBENBERG:  I think this is a good bill, and it does two things. You know, one, obviously the 20-week, 5-month prohibition, and then the patient safety. And I'll tell you, I don't know how it's going to affect abortions on the other parts of the bill, you know, with the ambulatory surgical centers and the hospital privileges. I do know that I do very strongly believe that this bill, you know, should a woman have an abortion, she's going to have it in a much safer condition and place. I do believe that.

S. TURNER:  Right. I raise the concerns––I mean, it does concern me that we did not put the amendment on, for example, with the exceptions to rape and incest. I mean, that does concern me.

LAUBENBERG:  Well, now you know rape and incest is not prohibited for five months.

S. TURNER:  Well, I understand that. I think the amendment though would have gone a long way––

LAUBENBERG:  I didn't restrict that.

S. TURNER:  Right. I think the amendment that Representative Thompson offered would have gone a long way in really clarifying SB 5 as it relates to those two areas. But my only reason for rising today is, having been here now for 24 years, and over the last several sessions, we have continued to deal with this issue, which is a very personal, very emotional issue, and I respect anybody's view on that issue. You know, we don't necessarily have to agree with the legislation on it, but I certainly respect people's right to carry. And so, my concern is at what point, at what point have we sufficiently covered this area where we can move on to something else? And if the goal of you and others is to eliminate abortions, and so we're going to continue down this continuum until that is achieved, I respect that.

LAUBENBERG:  Right.

S. TURNER:  I may not agree with it, but I respect that. And SB 5, certainly from your vantage point, will move us in that direction. Is that a fair characterization?

LAUBENBERG:  You know, I don't know that you will ever eliminate abortion 100 percent. I think science and technology as we move forward brings us different––

S. TURNER:  Well, let me ask this, because I'm trying to get us to the finish line even though I may not agree with the finish line.

LAUBENBERG:  I don't know that there is ever a finish line.

S. TURNER:  Would you accept a third reading amendment that would simply ban abortions in the State of Texas that would take us all the way to, I think, where many people want to go? Would you accept that amendment so we can be done with this subject matter? If I offered that amendment to ban abortions––point blank ban it––and put it on SB 5––

LAUBENBERG:  I know, Representative Turner. You know, like I said last night, I wanted to keep the bill as it was.

S. TURNER:  But would you agree with that amendment, or be in opposition to that amendment, if I offered an amendment to simply ban abortions outright in the State of Texas?

LAUBENBERG:  No, I could not accept that.

S. TURNER:  And the reason being?

LAUBENBERG:  Honestly, I have been here––I have not left the Capitol all night, so you have me at a disadvantage on my clarity of thinking this morning. I will be very honest with you. I said last night that I wanted to keep the bill as it is, and I am committed to that.

S. TURNER:  I understand. Again, I'm going back to the original part that––

LAUBENBERG:  I know, and that was my answer.

S. TURNER:  Okay, and so, if there is an amendment to––

LAUBENBERG:  That was my answer.

S. TURNER:  ––ban abortions outright, you would not accept that amendment?

LAUBENBERG:  No, I would not accept that.

S. TURNER:  To ban it?

LAUBENBERG:  Yes, sir.

S. TURNER:  Okay, but that is not to say at some point down the road, maybe in another session or another special, that Representative Laubenberg might not carry a bill that would simply outright ban abortions? That would be consistent to where you want to head, I would imagine. That's the final destination, whether we want to acknowledge it or not, but that is the final destination that you would like to see, where you would like to see us go.

LAUBENBERG:  Representative Turner, you know, I feel like I'm––very respectfully, I gave you my answer. I'm trying to be as honest as I can. You know where I stand on things, and this is where I want the bill to be right now. I cannot predict the future.

S. TURNER:  No, and I understand that, and I accept that. Thank you very much.

FARRAR:  I had some questions––follow-up to Chairman Turner. Do you have other strategies besides restricting access to clinics to reduce the abortion rate?

LAUBENBERG:  Representative Farrar, right now my goal is to pass this bill.

FARRAR:  I understand, but what I'm talking about––because what he's saying is, are we going to continue to see this legislation every session? So, my question is, do you have efforts outside of closing clinics and putting up burdens––do you have other strategies to reduce the abortion rate besides closing clinics?

LAUBENBERG:  Representative Farrar, I have no strategies. I promise you, I have no strategies. You know, someone carried a bill last session that dealt with a different issue. I am carrying this bill, and it is not my intent to restrict access to women.

FARRAR:  But you understand that this will have that effect because you've made no provisions? We tried to extend the deadline; we tried to do other things so that it would be a seamless transition for women, but it won't be under your bill. There's not enough time, and there'll be five clinics, you're aware of that?

LAUBENBERG:  No, it will not be just five clinics. This bill is designed to improve the clinics and make it better for women going through an abortion.

FARRAR:  Right now––

LAUBENBERG:  It really is the health and safety.

FARRAR:  Are you aware that today there are only five ambulatory surgical centers that meet this requirement?

LAUBENBERG:  And they have until September 2014.

FARRAR:  Right. That's simply not enough time. We offered an amendment to have one more year extended, and you did not accept that. So, let me ask you this, are you aware of the cost of abortion care in a clinic versus in an ambulatory surgical center? Are you aware of the difference in the cost?

LAUBENBERG:  Representative Farrar, again, I will apologize for my lack of sleep, but I just again want to emphasize this is all about patient safety.

FARRAR:  I don't question your motives. I'm saying though, do you know the cost? I mean, that's a pretty simple one. I'd imagine you'd know the cost between abortion care in a clinic setting versus abortion care in an ambulatory surgical.

LAUBENBERG:  I'm sorry. A lot of the cost will depend on the term of the pregnancy, complications---there's various factors.

FARRAR:  Okay, let's single it out to an early, say an eight-week situation.

LAUBENBERG:  Again, it comes down to health and safety and conditions of the woman.

FARRAR:  Typical. Okay, but I'm talking about a typical?

LAUBENBERG:  Representative Farrar, I think you probably know that better than I do.

FARRAR:  Well, I think you should know that, because it goes to the question of access. Because if the cost is tremendously more and it's a needless requirement to take them to an ambulatory surgical center, then I think you should know that. But, I will educate you. It's about $450 at a clinic, in a clinic setting, and it's over $1,200 at an ambulatory surgical center. And do you agree with me that that will place a burden on women?

LAUBENBERG:  Representative Farrar, again, this is about the safety of the woman.

FARRAR:  Do you agree with me that that will be a burden for the woman?

LAUBENBERG:  Representative Farrar, unless I can, you know, verify the numbers, I again just want to emphasize that this is about the health and safety of the woman.

FARRAR:  Okay, let's suppose that was the case. Would you agree that that is a substantial burden?

LAUBENBERG:  Again, it has been a very, very long night. And, you know, we can start talking about, you know, the value of life, too. So, you know, I––

FARRAR:  That's not my question, and we can debate that question another time. In this question, I'm just asking you if that is a substantial burden. But, I see the resistance in answering the questions, so I'll go no further on that. In your bill, it requires that all treatment---including nonsurgical, so pharmacological---all treatment would be required in an ambulatory surgical center, correct?

LAUBENBERG:  Correct.

FARRAR:  Okay, I have––that question was not asked yesterday. Also, I don't think questions were asked yesterday about legal challenges in other states. Are you aware of these legal challenges on the 20-week bans in other states?

LAUBENBERG:  I am aware of some of the challenges, but there are also states where, you know, it hasn't been challenged yet. Because of the issue, I have no doubt there will always be a challenge.

FARRAR:  Do you know that a similar law was challenged in Iowa?

LAUBENBERG:  I'm not real familiar with all the details of that, but you know what? This is what we're going to pass in Texas.

FARRAR:  Well, do you know the result of that case? I think it's important because it has implications on this case.

LAUBENBERG:  It really isn't relevant to this because each state has their own different tweaks in the bill, and you also have different courts that it goes through, as well.

FARRAR:  Well, we are all subject to the provisions of the Ninth Amendment. All states are. And this is a federal court, and I'll tell you what happened––

LAUBENBERG:  No, I know.

FARRAR:  A federal court struck down Idaho's 20-week ban. In fact, the holding was by Judge Winmill. He says, "The state's clear disregard of this controlling Supreme Court precedent and its apparent determination to define viability in a manner specifically and repeatedly condemned by the Supreme Court evinces an intent to place an insurmountable obstacle in the path of women seeking non-therapeutic abortions of a nonviable fetus at and after 20 weeks."

LAUBENBERG:  Is that a court that has jurisdiction over Texas?

FARRAR:  It is not. We're subject to the same ruling. We are subject to the same provisions of the constitution.

LAUBENBERG:  What we're finding, you have different courts, different opinions. And so, I welcome this one working its way through that system that has jurisdiction over Texas.

REPRESENTATIVE HOWARD:  Representative Laubenberg, I wanted to ask you, when the implementation occurs with this bill, when will it begin to take effect?

LAUBENBERG:  The bill will take effect in 91 days, you know, unless there is 100 votes to have it take effect immediately. Now, there are parts of the bill that will take effect September 2014.

HOWARD:  And which parts would those be?

LAUBENBERG:  The ambulatory surgical centers.

HOWARD:  So, you're going to give the facilities––

LAUBENBERG:  More time.

HOWARD:  ––a little over a year––

LAUBENBERG:  Yes.

HOWARD:  ––to come online?

LAUBENBERG:  Yes.

HOWARD:  Are you aware of how long it took the facilities to come online when the legislation was passed, I believe it was 2003, to require that––

[Time expired.]

REPRESENTATIVE BURNAM:  Mr. Speaker, members, earlier this morning, one of the two amendments that I had for consideration during second reading was the amendment that we didn't get to when the 25-plus of you decided to cut off this discussion and dialogue. I thought it was a really important amendment that talked about women's health care and the fact that Texas has one of the absolute worst records when it comes to children's heath care and women's health care of not only any state in this country, but any place in this world. And I wanted the opportunity to talk about that. So, this morning, when I got up bright and early, I decided to refile all the amendments that were cut off last night, because I think all these amendments deserve consideration and public discussion. But, out of respect to the process, which not everybody here shows, I'm going to withdraw all of those amendments so we can continue in the closings on the third reading on this bill.

FARRAR:  SB 5 was brought under the guise of raising the standard of care for women, but we know---we've heard over and over again---it is simply an appeal to primary voters. By shutting down abortion clinics so that women have to travel far from home, by tripling the cost of their care, and by overriding current best medical practices to burden women with needless overregulation, the State of Texas is going to put women in jeopardy in an effort to force women into not having an abortion. I asked the author of the bill if she had other strategies to reduce the abortion rate. Comprehensive sex ed, that would be a great first step. Increasing access to reproductive health care would be another tremendously effective step. None of those were in her response. I believe these are better ways to reduce the abortion rate.

If this bill is really about raising the standard of care for women, shouldn't the medical community support it? They don't. You've heard the Texas Medical Association, the Texas Hospital Association, and the American Congress of Obstetricians and Gynecologists all oppose this legislation. That's because SB 5 is not about making abortion safer for women. It's about putting undue burdens on women seeking safe and legal abortion care in order to restrict access. Moreover, provisions in this bill continue to override the doctor-patient relationship for women who are making highly personal decisions, the most personal of decisions. We as legislators have no business telling a doctor how to best treat a patient. Each patient is a unique individual with a unique set of circumstances. We should not tie the hands of doctors. We have no medical training. We have no qualifications to override their training. We should not require them to take a one-size-fits-all approach to health care. A woman, under the guidance of her doctor and with input from her family, is in the best place to make decisions about all of her health care, including her reproductive health.

While we have heard claims that this bill is for women's health, we know that restricting access to abortions actually harms women's health. History is ripe with stories of women taking desperate measures when they were unable to access safe and legal abortion care. Our constituents sent us here to move forward, not backward in time.

If this bill passes, the vast majority, 80 percent, of Texas abortion clinics will close. The ones that remain open will be in urban areas, as you heard, far away from the many Texans who live in rural areas. As you know as well, we live in a vast geographic state, we live in a big state. Mexico is a closer drive from South Texas than San Antonio. In desperate times, a South Texas woman may choose to cross the border for abortion care, but will lack the medical care and follow-up that a licensed physician in Texas near her could give her. Botched, unhealthy abortions can lead to infertility, infections, or even death. This bill is not about responsible government to not think through situations like this.

We can also be sure that if this bill passes, the state will be subjected to costly litigation. That's what has happened in other states that have passed similar 20-week bans. In fact, in Idaho, Arkansas, Arizona, and Georgia courts have either struck down the 20-week bans for being unconstitutional or have issued preliminary injunctions. I thought the majority party, the Republican Party, was about less regulation, less government intrusion, less litigation. But, when it comes to women, it turns those arguments on its head. Because what this bill does is it overregulates, it puts government in the middle of a very personal decision, and it subjects the state to costly litigation.

No, members, these bills are not about women's health. We haven't even heard much to defend that stance. We haven't heard from republicans about why we should support this bill. We haven't heard from this bill's author on the amendments that she universally tabled. And now, the republican majority has moved the previous question––sorry, I wrote these earlier last night---anticipated the previous question, but that was on the table this morning and that was negotiated off of the table this morning in an effort to keep this process open. And, I think that was the right thing to do. This debate will end soon, but it's only on the agreement of those who are concerned, folks that negotiated that to make sure that a boot wasn't placed on our necks of the minority party here.

REPRESENTATIVE GIDDINGS:  Ms. Farrar, are you familiar with the fact that there is some misinformation in a publication that every doctor has to give to a patient based on state law?

FARRAR:  Yes.

GIDDINGS:  Are you familiar with the fact that in that publication there's a statement that says that abortion is linked with breast cancer?

FARRAR:  Yes, I assume that's the pamphlet you are talking about. Yes.

GIDDINGS:  Yes. That was an amendment that I had last evening, so I know we're not going to go into that just yet. But, do you know that the National Cancer Institute has concluded that induced abortion is not associated with an increased risk in breast cancer?

FARRAR:  I am aware.

GIDDINGS:  Are you aware that the American College of Obstetricians and Gynecologists are saying the same?

FARRAR:  I am.

GIDDINGS:  The American Cancer Society is saying the same?

FARRAR:  I am.

GIDDINGS:  Are you also aware that the largest and probably the most reliable study on this topic was done during the 1990s in Denmark, a country with very detailed medical records on all citizens, and that in that study––it was very complete, it was not influenced by recall bias––but that study also said that there was no link?

FARRAR:  I have heard of that study.

GIDDINGS:  My last question, are you further aware that, as a matter of fact, the U.S. National Cancer Institute, NCI, concluded that breast cancer risk is increased for a short time after a full term pregnancy that results in the birth of a living child? This is from the American Cancer Society. Are you aware of that?

FARRAR:  I was not aware of that stat.

GIDDINGS:   I just think it is not the right thing to do to have misinformation printed in a publication that is authorized by law. Would you agree?

FARRAR:  I agree with you, Representative Giddings, that it is troubling that this body––we are not medically trained, yet we are usurping those that are medically trained for political expediency, quite frankly. And that causes concern, because it's one thing to win elections, but it's another thing to affect the lives of women and a lot of these.

NAISHTAT:  Members, I'm going to make an unusual closing. I had many, many constituents who did not get an opportunity to testify before the State Affairs Committee. Some of them waited eight or nine hours, and I would like to share with you the testimony of three of my constituents who did not have the opportunity to testify.

"My name is Amy and I am here representing myself. I am also a volunteer with The Lilith Fund, an abortion assistance fund which speaks directly to low income women needing abortion care but unable to access it because of cost, distance, and many other reasons. I am here to testify against the bills because it is important that abortion remain legal, safe, and accessible for all Texas women. I had an abortion when I was 23. I was unemployed and suffering from health problems. My life wasn't stable enough to provide a home for a child, and my health wasn't sturdy enough to continue the pregnancy. I had to borrow money for the abortion, but I was fortunate enough to live close to a clinic. My abortion was safe and professional and I recovered from it quickly.

However, my abortion was a wake-up call. I decided that if I were to get pregnant again, I wanted to be in a better position to have a healthy pregnancy and provide a stable home for a child. I got a job that led to a career, I went to grad school, and I worked on improving my health.

As it turns out, I have never gotten pregnant again. But, in the course of dealing with my health issues, I discovered that I have a genetic condition. It isn't fatal, but it does lead to a decreased life expectancy, a decreased quality of life, and a far greater chance of developing major fetal diseases and a decreased quality of life. The worst part of it is the constant chronic pain that this condition causes. No matter the treatment or how well I take care of myself, I have to live with chronic pain which gets worse every year.

If I were to get pregnant again, I could not imagine sentencing a child to a life of constant, chronic pain due to some bad genes. My bad genes. While I take every precaution to make sure that I don't get pregnant, birth control sometimes fails and rapes sometimes happen. If I were to get pregnant again, I would have an abortion, despite having a master's degree, despite having a good job and health insurance, despite being able to provide a stable and loving home for a child.

It is my hope for every woman who is not able or willing to continue a pregnancy for whatever reason, that she can have access to a safe, professional, and legal abortion. But, if these bills pass, it will guarantee the end of safe, professional, accessible, and legal abortion for a large number of Texas women. These bills put undue burdens on women, and these bills will prevent women from being able to choose what's best for them, their health, their families, and their futures. Please do not vote for these bills. Thank you."

The second one:

"My name is Andrea, and I am here representing myself, testifying in strong opposition to these bills. I believe the practical effects of this bill are clear: it would significantly reduce access to safe, legal abortion in the State of Texas, and that scares me. And I'm a Texan lady, so not a lot scares me. I've done some barrel racing; I've seen big 'ole snakes out in the Hill Country and bar brawls on Sixth Street. But this legislation is terrifying, and I'll tell you why.

The so-called "Preborn Pain Act" ignores sound, mainstream medical science supported by the American Medical Association and the American College of Gynecologists. The restrictions on the administration of medical abortions would prevent Texans in rural areas from safely and swiftly obtaining medication that would allow them to end their pregnancies without multiple unnecessary visits to a doctor's office, or if this legislation passes, an ambulatory surgical center hundreds of miles from home. And I have yet to hear from a legislator who can provide any evidence whatsoever that shows abortions performed in ambulatory surgical centers are safer than those performed in licensed abortion facilities.

There is a reason you're hearing from me, and women who look and sound like me, today. I am an affluent, white, English-speaking woman with a flexible job who lives in an urban area. I will always be able to get an abortion if I need one. But the Texans who will be disproportionately negatively affected by this legislation are not able to take time off work, arrange child care, and drive hundreds of miles to sit in a cold, sterile room, either in hopes of getting an abortion or in hopes of testifying at a Capitol committee hearing.

But, in closing, what scares me most of all is the confusing and appalling fact that some of the members of this committee argued earlier today that intent is not important when drafting legislation. If that is the case, I wonder why these bills include language about a compelling state interest in fetal pain in the first place? If we are legislating without intent, we are shooting blind. And, as a Texas lady, I know one of the things we're real proud of here is our aim.

I want to respectfully ask that you vote to keep state government out of my uterus."

And the last letter:

"My name is Kailey. I am here today to speak for myself and to voice my opposition to this legislation. I am opposed as a social worker, a health care professional and abortion provider, and as a woman. I will not abide when others try to legislate away my rights by creating undue and unnecessary restrictions on a legal medical procedure. I do not want to live in a place where women are not trusted to make private decisions for themselves without legislative interference.

I believe that decreasing access to abortion for political and religious reasons is bad and unconstitutional health policy. It does not serve to protect the health and safety of women. Limiting access to an already safe, medical procedure, indeed safer than carrying a pregnancy to term, will force women into unsafe at home abortions or into the arms of unscrupulous people who take advantage of desperate women.

Lastly, and most importantly, I trust women to decide what is best for them and that includes access to abortion on demand and without apology."

Thank you very much, members.

C. TURNER:  Members, nobody likes abortion. Nobody wants there to be more abortion. If we were truly interested in reducing the number of abortions, we would be having a debate not about this bill, but a debate about how to reduce unintended pregnancies. But we're not having that debate. Because if we were truly serious about reducing unintended pregnancies, this legislature wouldn't have cut the Women's Health Program two years ago or cut family planning services from our budget. Or, in this legislative session, refused to insure more than one million adults, half of whom are women, who are eligible for health care under Medicaid expansion under the Affordable Care Act. We didn't do any of those things. If we were serious about reducing unintended pregnancies, we would have evidence-based sex education in our high schools, but we won't do that. If we were serious about reducing unintended pregnancies, we would make contraception more accessible to women, not less.

This bill has never been, nor will it ever be, about women's health and safety. If it were about women's health, we would be doing everything we could to change Texas' position from being the last in insured residents in the nation, but we're not. What this bill is about, always has been and always will be, is political posturing. It's about partisan politics. It's about republican primaries, and that's a shame. Posturing to an extreme faction in our state, the tiny fraction faction, doesn't represent the people in my district, and I don't think it represents the people in most districts in this state. Is politics really worth the expense of the health of Texas women? I will never know how difficult a decision it is for a woman to make a heart-wrenching and life changing decision, often in circumstances none of us could understand, that I will never understand that. But, I can't even imagine how difficult it is.

But, as I close, we've talked a lot about fetal pain in this debate and the 20-week ban. I'd like to quote briefly the op-ed that ran in the New York Times late last week that my mother pointed out to me. It's by a woman named Judy Nicastro who was pregnant with twins. And she writes that:

"But in my 20th week, during an ultrasound, the technician looked concerned, and we got the first hint that something might be wrong. The next day, a Friday, my obstetrician called to say that the technician had had a hard time seeing the heart of the male fetus. "It is probably just the position," she reassured me. I wasn't reassured. On Monday, I had a second ultrasound and my husband and I spent two hours––it felt like an eternity––with a different doctor and technician. 'It looks as if the boy has a herniated diaphragm,' they told us. 'All the organs are in his chest and not developing.' I began sobbing. What did that mean? Would the organs move? Was my baby "fixable"? The clinic staff members were reluctant to tell us how bad it was. They said I needed an MRI, which would provide more details."

And, a little later in the piece, she says:

"The surgeon described interventions that would give our son the best chance of surviving birth. But the pediatrician could tell that we were looking for candid guidance. He cautioned that medical ethics constrained what he could say, then added, 'Termination is a reasonable option, and a reasonable option that I can support.' The surgeon and nurse nodded in agreement. I burst out sobbing. My husband cried, too. But in a sense, the pediatrician's words were a source of comfort and kindness. He said what we already knew. But we needed to hear it from professionals, who knew we were good parents who wanted what was best for our children. . .We made sure our son was not born only to suffer."

This piece was written in direct response to a similar piece of legislation that was considered in the United States House of Representatives last week and passed by the republican majority there.

Members, as we close this debate and prepare to vote on SB 5, we know how this vote is going to end up in this house. But let's not say it's about women's health. Let's not say it's about women's safety. Let's admit it for what it is: it's partisan politics. It's partisan politics at its very worst.

G. BONNEN:  Members, I really appreciate your patience, your attention, and most of all, your endurance. You know, we've been here I don't know how long now, most of us without sleep throughout the night. And, I would like to just give you a little bit of perspective on some of the specific aspects on this bill. I've visited with you a little bit last night about fetal pain. This morning, we heard some assertions that this bill is all about eliminating abortion, that that is somehow the intent, and it genuinely is not. This is truly about patient safety, and I'd like to give you some specific understanding of how that comes about.

So, for example, physician credentialing and how we determine who is capable and able to perform certain procedures. A medical student goes to school. They finish medical school. They do a one year internship, and after their examinations, they have a license. And, at that point, from the standpoint of their medical licensure, they can do anything. They can do heart transplants, they can do brain surgery, they can perform abortions. Why does that not happen? Well, aside from the practical, obvious reasons for that you have to perform those in a suitable facility, and facilities have requirements. They have regulations. In fact, they have a credentialing committee. It's a committee of physicians, nurses, and administrators who review the applications of physicians who would like to work in that facility. And, those physicians have to delineate the specific services they wish to render. So, if you're a gastroenterologist, you list those procedures that you would like to do. You won't be credentialed to perform cardiac catheterizations. You will likely be credentialed to perform colonoscopies. So, this is a peer review process. It's a process that occurs typically every two years. And it is a measure of credentialing and safety that occurs in that environment. And this is something that is missing when we speak of abortion and abortion clinics.

We have heard some really tragic stories. Last night, Representative Dukes shared with us a terrible story of a young lady who went to have an abortion. She went home; she had excessive bleeding. She was taken by her family to a hospital, was fortunately treated, her life was saved, and she was unable to have children after that, as I understand it. I'd like to know where she had that procedure performed. I think the odds are it was in an abortion clinic. The implication was this was in some nefarious facility that wouldn't pass current standards. The likelihood is that that's not true. I am not going to rehash for you the atrocities that we've seen in Philadelphia and recently in Houston, Texas. So, anyone who says that the current standard, that the current status quo is satisfactory is not paying attention. And, the standards that are proposed in this piece of legislation brings abortion providers, physicians, and facilities up to a standard that is commonplace throughout the rest of medicine.

Now, I also want to tell you that I really feel blessed to have been a part of this process, and I appreciate our colleagues who have had the courage to represent their constituents and their core convictions. I appreciate our colleagues who have stood with Representative Laubenberg through this process. And I think that we can vet our differences, have these types of dialogue, and vote and establish good policy is a true blessing. It makes me proud to be an American; it makes me proud to be a Texan. So, with that I would like to move passage.

FARRAR:  Representative Bonnen, are you familiar---well, you should be familiar. You are on a YouTube video with yourself and the copy of the Journal of the Medical Association. You can see it right here. And, if you look closely––you are a neurosurgeon, I believe?

G. BONNEN:  That's correct.

FARRAR:  Okay, so you would know these things. But this thing that is in your background says that this is a JAMA article. It says conclusions, and I'm perplexed because if you read it––and I think, it's at 1:45 into the video––and so, you are talking about how there is fetal pain and on and on, and you're using this sort of to substantiate your position. But, a viewer, if they look closely––because you think, "Oh wow, that's the JAMA." So, if you look closely, the conclusion says "evidence regarding the capacity for fetal pain is limited, but indicates that fetal perception of pain is unlikely before the third trimester."

G. BONNEN:  Yes.

FARRAR:  And so, I'm curious––

G. BONNEN:  I really appreciate you mentioning that, and I've noted your infatuation with that article because this is the third time that you have brought this to my attention. And I ran out of time last night when you brought it to my attention for the second time, so I am glad you're giving me this opportunity to point out to you that the reason that is in the background is because my testimony is refuting what is in that article. And that is the article that I explained to you last night was authored by a medical student, an attorney who had worked for NARAL Pro-Choice and––

FARRAR:  I beg to differ.

G. BONNEN:  Excuse me. As I said, that article, the bottom line is not being used in support of the physician, but rather to demonstrate that I do not agree with that position.

FARRAR:  You were not refuting this article in what you were saying in the video. What you just said is not exact.

G. BONNEN:  I appreciate your comments. Mr. Speaker, I move passage. Thank you.

FARRAR:  So, I just want to clarify that, that you were not refuting this article in that video.

[SB 5 was passed by Record No. 52.]