After considering hours of public testimony at an August hearing and more than 12,000 comments submitted in writing, the state made no changes to the rules, which are set to be published in the Texas Register on Sept. 30.

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The rules were republished “after reviewing the feedback and comments we received,” health commission spokeswoman Carrie Williams said on Wednesday. This will require another 30-day public comment period before the rules can go into effect.

With little notice and no announcement, the proposed rules were first published in the Texas Register on July 1 at the direction of Republican Gov. Greg Abbott. The health commission has said the rules will result in “enhanced protection of the health and safety of the public.” Abbott said in a fundraising email that the rules were proposed because he doesn’t believe fetal remains should be “treated like medical waste and disposed of in landfills.”

The proposed rule has prompted outrage from the reproductive rights community, which has accused state leaders of enacting unnecessary regulations. Medical providers — including the Texas Medical Association and the Texas Hospital Association — also questioned why the rule change does not allow an exception for miscarriages and ectopic pregnancies.

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Despite making no revisions to the rules themselves, the commission has amended its analysis on the financial impact of the rule on health care organizations that must comply, saying the rules won’t increase “total costs” for health care facilities.

Medical professionals and funeral directors had raised concerns about who would bear the costs associated with cremation or burial — a figure that can reach several thousands dollars in each case — and questioned whether the new rule would trigger a requirement for death certificates so that fetal remains could be cremated or buried. (Under current rules, the state requires funeral directors or a “person acting as such” who take custody of a dead body or fetus to obtain an electronic report of death before transporting the body, according to the Funeral Consumers Alliance of Texas.)

The amended fiscal analysis indicates that the methods allowed in the proposed rules “may have a cost” but “that cost is expected to be offset” by costs currently incurred by facilities. Hospitals and abortion providers currently contract with third-party medical waste disposal services.

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The changes were made “to help people better understand the impact of the rules,” Williams said.

The health commission also appears to have ignored a suggestion from the antiabortion group Texas Right to Life that the health commission should clarify the rules so they do not apply to miscarriages that occur at home — a requirement, opponents reiterated, could require a woman who miscarries at home to carry the fetal tissue or blood products of a miscarriage to a doctor’s office or hospital.