Monitoring the Session

SB 619

Sparks Conscience Bill Lets Health Care Workers Decline Specific Services

Died in committee

Verdict: No flags

No flagsInitial review
Sen. Kevin SparksRSenate 31

Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to protection of persons from participation in a health care service for reasons of conscience; providing a civil remedy; authorizing disciplinary action.

Caption from analyzed text · version I.

Summary

Emergencies and life-sustaining treatment excepted. Punished workers can sue for damages and attorney’s fees.

The bill lets any person in Texas health care decline to take part in a specific health care service for reasons of conscience, except emergency care and life-sustaining treatment. It covers doctors, nurses, pharmacists, aides, students, and anyone who helps deliver care, and it bars employers, schools, licensing bodies, and public officials from punishing them for declining. Health care facilities must write a protocol by December 1, 2025, for getting patients timely access to the service, and people who are punished can sue for damages and attorney's fees or file a licensing complaint.

Labels

Labels: ZOMBIE BILL. Died 2 times: 88R HB 319 by Rep. Oliverson (Died in committee) and this bill (Died in committee). Checked against 88R only.DO-OVER. Reworked text of a bill filed before that died: 88R HB 319 by Rep. Oliverson (Died in committee). Filed in 2 sessions, counting this one. Checked against 88R only.TRY NO. 2. Filed in 2 sessions: 88R and 89R. Checked against 88R only.GOT HALFWAY. Passed the Senate on Apr 30, 2025. Died in the House: never got out of the Public Health committee.

Receipt

The receipt

89R-SB619 · 2024-12-13

SOLD BY

+ 7 coauthors

ITEM

relating to protection of persons from participation in a health care service for reasons of conscience; providing a civil remedy; authorizing disciplinary action.

WHAT IT DOES

Emergencies and life-sustaining treatment excepted. Punished workers can sue for damages and attorney’s fees.

The bill lets any person in Texas health care decline to take part in a specific health care service for reasons of conscience, except emergency care and life-sustaining treatment. It covers doctors, nurses, pharmacists, aides, students, and anyone who helps deliver care, and it bars employers, schools, licensing bodies, and public officials from punishing them for declining. Health care facilities must write a protocol by December 1, 2025, for getting patients timely access to the service, and people who are punished can sue for damages and attorney's fees or file a licensing complaint.

CHARGES

[ ] NONE FOUND

TOTAL

No first-year general revenue figure available here.

LBB estimate · fiscal note version I · source

Sources

Fiscal note · version I · March 17, 2025

The fiscal implications of the bill cannot be determined as the necessary information to make appropriate assumptions to determine the fiscal impact is unknown. This includes case-level information at The Office of Court Administration and the Comptroller of Public Accounts and the impact to the Health and Human Services Commission's (HHSC) Regulatory Services Division's complaint intake process.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

  1. Received by the Secretary of the Senate
  2. Filed
  3. Read first time
  4. Referred to Health & Human Services
  5. Scheduled for public hearing on . . .
  6. Considered in public hearing
  7. Testimony taken in committee
  8. Left pending in committee
  9. Considered in public hearing
  10. Vote taken in committee
  11. Reported favorably w/o amendments
  12. Committee report printed and distributed
  13. Placed on intent calendar
  14. Not again placed on intent calendar
  15. Placed on intent calendar
  16. Co-author authorized
  17. Rules suspended-Regular order of business
  18. Record vote
  19. Read 2nd time & passed to engrossment
  20. Record vote
  21. Rules suspended-Regular order of business
  22. Record vote
  23. Read 3rd time
  24. Passed
  25. Record vote
  26. Reported engrossed
  27. Received from the Senate
  28. Read first time
  29. Referred to Public Health
FILED UNDER

SPEECH AND LAWFARE

THE TEXT

“A person who is injured by a violation of this subchapter may bring a civil action against a person who violates this subchapter.”

Bill text, introduced version (I)

Analysis prose withheld. Source quote shown.

SIGNED FOR BY

Senate · 20 yea · 11 nay

Sources

Senate: Final passage · Apr 30, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Donors

Texans for Lawsuit Reform PAC$60KKyle & Jamie Stallings$25,000Tim Dunn$25,000

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Jul 25, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$60,000.00

Texans for Lawsuit Reform PAC

$60,000.00

Cash
$60,000.00
Paid by others
$0.00
Total
$60,000.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Oct 15, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101012623, 101029380, 101072732.

Kyle & Jamie Stallings$25,000.00
Tim Dunn$25,000.00
Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$60,000.00

Cash
$60,000.00
Paid by others
$0.00
Total
$60,000.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Oct 15, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101012623, 101029380, 101072732.

Votes4

Senate Apr 30, 2025

Yea
20
Nay
11
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read third time and was passed by the following vote: Yeas 20, Nays 11. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 20 (published)
  • Nay: 11 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate Apr 30, 2025

Yea
20
Nay
11
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Sparks moved to suspend the regular order of business to take up for consideration SB 619 at this time on its third reading and final passage: SB 619, Relating to protection of persons from participation in a health care service for reasons of conscience; providing a civil remedy; authorizing disciplinary action. The motion prevailed by the following vote: Yeas 20, Nays 11.

Published stock of positions for this vote, except where marked derived.

  • Yea: 20 (published)
  • Nay: 11 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate Apr 29, 2025

Yea
20
Nay
11
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read second time and was passed to engrossment by the following vote: Yeas 20, Nays 11. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 20 (published)
  • Nay: 11 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate Apr 29, 2025

Yea
20
Nay
11
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Sparks moved to suspend the regular order of business to take up for consideration SB 619 at this time on its second reading: SB 619, Relating to protection of persons from participation in a health care service for reasons of conscience; providing a civil remedy; authorizing disciplinary action. The motion prevailed by the following vote: Yeas 20, Nays 11.

Published stock of positions for this vote, except where marked derived.

  • Yea: 20 (published)
  • Nay: 11 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Witnesses299
For
32
Against
265
On
2
Names

For

  • Alliance Defending Freedom1 registration
  • Baptist General Convention of Texas Christian Life Commission1 registration
  • Make Texans Healthy Again1 registration
  • Self11 registrations
  • Self; Protect Texas Fragile Kids1 registration
  • Self; Southern Baptists of Texas Convention1 registration
  • Self; Texans for Medical Freedom1 registration
  • Self; Texans for Vaccine Choice1 registration
  • Self; Texas Eagle Forum1 registration
  • Self; Texas Right To Know1 registration
  • Self; Texas Values Action1 registration
  • Self; True Texas Project4 registrations
  • Self; True TX Project1 registration
  • Texas Alliance for Life1 registration
  • Texas Faith & Freedom Coalition1 registration
  • Texas Right to Life1 registration
  • Texas Values2 registrations
  • The Texas Catholic Conference of Bishops1 registration

Against

  • Equality Texas1 registration
  • Self252 registrations
  • Self; ACLU of Texas1 registration
  • Self; Equality Texas1 registration
  • Self; Planned Parenthood Texas Votes1 registration
  • Self; Texas Freedom Network2 registrations
  • Self; Texas Unitarian Universalist Justice Ministry2 registrations
  • Self; Texas UU Justice Ministry2 registrations
  • Self; Transgender Education Network of Texas1 registration
  • Self; TUUJM1 registration
  • Texas Hospital Association1 registration

On

  • Health and Human Services Commission2 registrations
Sources

299 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

Senate witness list. Source snapshot 2026-10-20, Central time.

Fiscal

No first-year general revenue figure available here.

LBB estimate · fiscal note version I · source

Sources

Fiscal note · version I · March 17, 2025

The fiscal implications of the bill cannot be determined as the necessary information to make appropriate assumptions to determine the fiscal impact is unknown. This includes case-level information at The Office of Court Administration and the Comptroller of Public Accounts and the impact to the Health and Human Services Commission's (HHSC) Regulatory Services Division's complaint intake process.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

FILED BEFORE

Filed 2 times: 88R and 89R. Checked against 88R only.

88R HB 319

by Rep. Oliverson, different lead author · Died in committee · reworked

Introduced text

Last action, Feb 23, 2023: Referred to Public Health

Relating to protection of persons from participation in a health care service for reasons of conscience; providing a civil remedy; authorizing disciplinary action.

Caption, 88R bill history

Sources

Texas Senate · Filed Dec 13, 2024

05/02/2025 H Referred to Public Health: May 2 2025 2:03PM

Texas Legislature Online · Introduced · Senate Committee Report · Engrossed

Data snapshot Oct 26, 2026 at 4:19 AM CDT. Grades, charges, quotes and corrections follow the published record.

Coauthors

House committee · Public Health · Final status: Died in committee

Senate committee · Health & Human Services · Committee vote 6 aye, 3 nay · Out of committee

Subjects

Civil Remedies & Liabilities

Health Care Providers

Health--Emergency Services & Personnel

Occupational Regulation--Health Occupations

Religion

MEDICAL CARE FACILITIES

PHYSICIANS

Text

The text as introduced · 1,364 words

89R4858 KRM-D

By: Sparks
S.B. No. 619

A BILL TO BE ENTITLED

AN ACT

relating to protection of persons from participation in a health

care service for reasons of conscience; providing a civil remedy;

authorizing disciplinary action.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. The legislature finds that:

(1) the public policy of this state is to respect the

conscience of all health care providers and the right of each health

care provider to hold their own belief about whether certain health

care services are morally acceptable;

(2) without comprehensive protections, the conscience

of health care providers may be violated; and

(3) each health care provider must be protected from

required participation in a health care service in which the

provider has declined participation for reasons of conscience and

from discriminatory adverse action resulting from the

nonparticipation.

SECTION 2. Chapter 161, Health and Safety Code, is amended

by adding Subchapter Z to read as follows:

SUBCHAPTER Z. TEXAS HEALTH CARE CONSCIENCE PROTECTION ACT

Sec. 161.751. DEFINITIONS. In this subchapter:

(1) "Conscience" means a sincerely held set of moral

convictions arising from:

(A) a belief in and relation to God;

(B) a religious faith or spiritual practice; or

(C) a moral philosophy or ethical position,

without regard to whether the philosophy or position is related to a

religious faith.

(2) "Emergency care" means bona fide emergency

services provided after a sudden onset of a medical or traumatic

condition manifested by acute symptoms of sufficient severity,

including severe pain, that the absence of immediate medical

attention could reasonably be expected to:

(A) place the patient's health in serious

jeopardy;

(B) result in serious impairment to the patient's

bodily functions; or

(C) result in serious dysfunction of any bodily

organ or body part of the patient.

(3) "Health care facility" means a public or private

organization, corporation, partnership, sole proprietorship,

association, agency, network, joint venture, or other entity that

provides health care services to patients. The term includes a

hospital, clinic, medical center, ambulatory surgical center,

private physician's office, pharmacy, nursing home, laboratory or

diagnostic facility, infirmary, dispensary, medical school,

nursing school, pharmacy school, or medical training facility.

(4) "Health care provider" means a nurse, nurse aide,

medical assistant, hospital employee, allied health professional,

laboratory technician, clinic employee, nursing home employee,

pharmacist, pharmacy employee, researcher, medical, pharmacy, or

nursing school student, professional, paraprofessional, or,

regardless of whether the person holds a license, any other person

who furnishes or assists in the furnishing of a health care service.

(5) "Health care service" means any phase of patient

health care or treatment. The term includes:

(A) examination, testing, diagnosis, referral,

prognosis, dispensing or administering a drug or device, ancillary

research, instruction, therapy, treatment, and preparing for or

performing a surgery or procedure;

(B) family planning, counseling, and referrals,

and any other advice in connection with the use or procurement of

contraceptives, sterilization, or abortion; and

(C) record preparation procedures, preparation

of treatment notes, and any other care or treatment rendered by a

health care facility, physician, or health care provider.

(6) "Physician" means an individual licensed to

practice medicine in this state.

Sec. 161.752. RIGHT TO DECLINE PARTICIPATION IN HEALTH CARE

SERVICE FOR REASONS OF CONSCIENCE; CONSTRUCTION OF SUBCHAPTER. (a)

Except as provided by Subsection (b), a person may decline to

participate in a health care service for reasons of conscience.

(b) A person may not decline to participate in the following

services:

(1) emergency care; or

(2) except as provided by Chapter 166, life-sustaining

treatment.

(c) Nothing in this subchapter may be construed to:

(1) supersede Chapter 166 governing the provision,

withholding, or withdrawing of life-sustaining treatment; or

(2) apply to emergency care, life-sustaining

treatment, or cardiopulmonary resuscitation.

(d) An exercise of the right of conscience under this

section is limited to a person's right to refuse to participate in a

specific health care service.

Sec. 161.753. IMMUNITY OF PHYSICIANS AND HEALTH CARE

PROVIDERS. A physician or health care provider may not be held

civilly or criminally liable because the physician or health care

provider declines to participate in a health care service wholly or

partly for reasons of conscience in accordance with Section

161.752.

Sec. 161.754. ADVERSE ACTION. A person, including a public

official and a medical school or other institution that conducts

education or training programs for physicians or health care

providers, violates this subchapter by taking an adverse action

against another person because the other person declines to

participate in a health care service for reasons of conscience in

accordance with Section 161.752. Violations include discrimination

against or taking an adverse action with regard to:

(1) licensure;

(2) certification;

(3) employment terms, benefits, seniority status,

promotion, or transfer;

(4) staff appointments or other privileges;

(5) denial of employment, admission, or participation

in a program for which the other person is eligible;

(6) reference to reasons of conscience in an

application form;

(7) questions regarding an applicant's participation

in providing a health care service for reasons of conscience;

(8) imposition of a burden in the terms or conditions

of employment;

(9) denial of aid, assistance, or benefits;

(10) conditional receipt of the aid, assistance, or

benefits; or

(11) coercion or disqualification of the other person

receiving aid, assistance, or benefits.

Sec. 161.755. PROTOCOL FOR DECLINING PARTICIPATION IN

PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall

develop a written protocol for circumstances in which a person

declines to participate in providing a health care service, other

than emergency care or life-sustaining treatment, for reasons of

conscience. The protocol must:

(1) describe a patient's access to health care

services and information to ensure the patient is not permanently

or substantially prevented from obtaining the services; and

(2) explain the process the facility will implement to

facilitate in a timely manner the patient's access to the services.

(b) A person who declines to participate in providing a

health care service for reasons of conscience shall:

(1) notify the health care facility of the

declination; and

(2) comply with the applicable protocol developed

under this section.

(c) This section does not permit a protocol developed under

this section to require a health care facility, physician, or

health care provider to counsel a patient or refer the patient to

another physician or facility regarding a health care service that

is contrary to the conscience of the physician or health care

provider.

Sec. 161.756. DISCIPLINARY ACTION; COMPLAINT. (a) A

health care facility, physician, or health care provider that holds

a license issued by a licensing agency in this state is subject to

review and disciplinary action by the licensing agency for a

violation of this subchapter as if the facility, physician, or

provider violated the applicable licensing law.

(b) A person who is injured by a violation of this

subchapter may file a complaint with the licensing agency that

issued a license to the health care facility, physician, or health

care provider that allegedly violated this subchapter.

(c) A physician or health care provider may not file a

complaint with the appropriate licensing agency under this section

unless the physician or health care provider complies with the

health care facility's protocol developed under Section 161.755.

Sec. 161.757. CIVIL REMEDIES. A person who is injured by a

violation of this subchapter may bring a civil action against a

person who violates this subchapter. A person who brings an action

under this section may obtain:

(1) injunctive relief;

(2) damages incurred by the person, including:

(A) actual damages for all psychological,

emotional, and physical injuries resulting from the violation of

this subchapter;

(B) court costs; and

(C) reasonable attorney's fees; or

(3) both injunctive relief and damages.

SECTION 3. Not later than December 1, 2025, a health care

facility, as that term is defined by Section 161.751, Health and

Safety Code, as added by this Act, shall develop a written protocol

as required by Section 161.755, Health and Safety Code, as added by

this Act.

SECTION 4. Section 161.753, Health and Safety Code, as

added by this Act, applies only to a cause of action that accrues on

or after the effective date of this Act.

SECTION 5. This Act takes effect September 1, 2025.