According to the Legislative Budget Board (LBB), HB 220 is estimated to have no significant fiscal implications for the State. The report notes that any additional costs associated with the bill’s new requirements—such as providing emergency contraception, offering showers, and ensuring access to certain survivor services—are expected to be absorbed using existing resources available to healthcare facilities and the relevant state agencies.

Similarly, the fiscal analysis concludes that there would be no significant fiscal impact on units of local government. Healthcare facilities, including those operated by local governments, are assumed to manage any compliance costs without requiring additional state funding or major operational changes.

Overall, the bill is structured in a way that expands survivors’ rights and facility obligations without triggering new appropriations, major administrative expansions, or unfunded mandates on state or local entities.

While the intent of HB 220 to provide comprehensive, trauma-informed care for sexual assault survivors is commendable, serious ethical and moral concerns justify opposing the bill. Emergency contraception (EC), particularly products like Plan B and Ella, has mechanisms of action that go beyond preventing ovulation. Scientific studies and pharmaceutical labeling evidence suggest that EC can also act after fertilization by altering the uterine lining to prevent implantation of a fertilized embryo​. From a pro-life perspective, human life begins at fertilization, not implantation; thus, any action that prevents implantation can result in the death of a newly created human life.

In addition, compelling healthcare providers to offer EC could violate their conscience rights. Providers with deeply held religious or moral beliefs about the sanctity of life from conception would be forced to participate in what they see as an act that could destroy human life. No meaningful conscience protections are included in HB  220 to safeguard against this coercion.

Opposition to the bill is not opposition to providing care, compassion, or justice for sexual assault survivors. Survivors deserve access to supportive and healing care. However, that care should not introduce the risk of further victimization by endangering new human life or forcing providers to act against their conscience. For these reasons, based on the moral concerns about EC's potential abortifacient effects and the absence of conscience protections, Texas Policy Research recommends that lawmakers vote NO on HB 220, consistent with a strong commitment to protecting both survivors and preborn human life.

• Individual Liberty: The bill enhances the individual liberty of sexual assault survivors by guaranteeing access to time-sensitive medical options like emergency contraception, with informed consent. It aims to restore agency to survivors who have had their bodily autonomy violated. However, it simultaneously threatens the individual liberty of healthcare providers who may have deeply held religious or moral objections to offering emergency contraception. Without explicit conscience protections, it forces individuals and institutions to participate in an act they may believe destroys innocent human life. Thus, the bill supports liberty for survivors but infringes on the liberty of medical professionals.
• Personal Responsibility: The bill empowers survivors to make their own medical decisions after an assault, contingent on their consent. This respects the idea that individuals are responsible for their own health decisions when informed. However, by mandating provider participation without allowing opt-outs based on conscience, it dilutes the principle that individuals (including providers) should be personally responsible for acting in accordance with their values, not government dictates.
• Free Enterprise: The bill places new regulatory burdens on healthcare facilities, requiring them to stock, offer, and possibly dispense emergency contraception. Even private hospitals — including religiously affiliated ones — would be bound by this mandate. This restricts the freedom of enterprise to set medical and ethical policies according to the mission of the institution, affecting operational autonomy.
• Private Property Rights: Mandating how facilities must use their resources (for example, stocking particular medications, offering them in all qualifying cases, staffing advocates) limits the property rights of hospital owners and operators. Even though these are public-facing businesses, the bill erodes the right to govern the use of one's private facilities and inventory, particularly for those who object to EC.
• Limited Government: The bill represents a notable expansion of state power into private medical decision-making between doctors, institutions, and patients. It mandates specific services under threat of regulatory penalties without respecting religious or ethical diversity among providers. Rather than respecting voluntary, locally determined standards of care, it imposes a one-size-fits-all rule from Austin.

• SB 1899 (Same As)