I 

116TH CONGRESS 

1ST SESSION H. R. 4428 

To establish a special enrollment period for family members of an individual 

who has died by suicide, to establish a competitive grant program to 

provide services and support to friends and family members impacted 

by an individual’s suicide, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 19, 2019 

Ms. WILD (for herself, Mr. TRONE, and Mr. MOULTON) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Oversight and Reform, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To establish a special enrollment period for family members 

of an individual who has died by suicide, to establish 

a competitive grant program to provide services and support to friends and family members impacted by an 

individual’s suicide, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Greater Mental Health 

5 Access Act’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) One in five adults in America experience 

4 some form of mental illness, and nearly one in twen5 ty-five adults live with serious mental illness. 

6 (2) Access to mental health services is a par7 ticularly pervasive problem; 28 million residents of 

8 the United States are uninsured and have no access 

9 to mental health services. Studies show that nearly 

10 60 percent of adults and 50 percent of children with 

11 a mental illness did not receive mental health serv12 ices in the previous calendar year. 

13 (3) The lack of access to mental health services 

14 has, in part, contributed to an increase in the sui15 cide rate in the United States, which is now the 

16 tenth leading cause of death in this country. 

17 (4) In 2017, 47,173 Americans died by suicide. 

18 (5) In 2017, there were an estimated 1,400,000 

19 suicide attempts in the United States. 

20 (6) Suicide by a loved one often results in ‘‘sui21 cide contagion’’; for surviving family and friends the 

22 risk of attempting suicide increases by 65 percent. 

23 (7) Family and friends who lost a loved one to 

24 suicide are 80 percent more likely to drop out of 

25 school or stop working. 


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1 (8) Access to mental health services is impor2 tant to mitigate suicide, suicide contagion, and be3 reavement. Access to care also reduces the financial 

4 burden for individuals in need of mental health serv5 ices. 

6 (9) The Patient Protection and Affordable Care 

7 Act has increased access to mental health services, 

8 but there is still a large population that is uninsured 

9 or has insufficient coverage to seek mental health 

10 services. 

11 (10) Family and friends who have lost a loved 

12 one to suicide should not face hurdles when attempt13 ing to access mental health services. As such, a sui14 cide or suicide attempt should constitute a ‘‘quali15 fying life event’’ for any individual who is eligible to 

16 enroll, but is not enrolled, in a health benefit plan 

17 under the Patient Protection and Affordable Care 

18 Act. 

19 SEC. 3. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD 

20 FOR FAMILY MEMBERS OF INDIVIDUALS WHO 

21 HAVE COMMITTED SUICIDE. 

22 (a) PUBLIC HEALTH SERVICE ACT.—Section 

23 2702(b)(2) of the Public Health Service Act (42 U.S.C. 

24 300gg–1(b)(2) is amended by inserting ‘‘including a spe25 cial enrollment period for family members of individuals 


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1 who have died by suicide, allowing them to enroll in, or 

2 change, their health care plan, beginning on the date on 

3 which the suicide is reported to the health insurance 

4 issuer’’ before the period at the end. 

5 (b) PATIENT PROTECTION AND AFFORDABLE CARE

6 ACT.—Section 1311(c)(6) of the Patient Protection and 

7 Affordable Care Act (42 U.S.C. 18031(c)(6)) is amend8 ed— 

9 (1) in subparagraph (C), by striking ‘‘and’’ at 

10 the end; 

11 (2) by redesignating subparagraph (D) as sub12 paragraph (E); and 

13 (3) by inserting after subparagraph (C) the fol14 lowing new subparagraph: 

15 ‘‘(D) a special enrollment period for family 

16 members of individuals who have died by sui17 cide, beginning on the date on which the suicide 

18 is reported to the Exchange; and’’. 

19 (c) SPECIAL ENROLLMENT PERIODS.—Section 

20 9801(f) of the Internal Revenue Code of 1986 (26 U.S.C. 

21 9801(f)) is amended by adding at the end the following 

22 new paragraph: 

23 ‘‘(4) FOR FAMILY MEMBERS OF INDIVIDUALS

24 WHO HAVE DIED BY SUICIDE.— 


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1 ‘‘(A) A group health plan shall permit an 

2 employee who is eligible, but not enrolled, for 

3 coverage under the terms of the plan (or a de4 pendent of such an employee if the dependent 

5 is eligible, but not enrolled, for coverage under 

6 such terms) to enroll for coverage under the 

7 terms of the plan upon the suicide of a family 

8 member, with the special enrollment period be9 ginning on the date on which the suicide is re10 ported to the group health plan. 

11 ‘‘(B) The Secretary shall promulgate regu12 lations with respect to the special enrollment 

13 period under subparagraph (A), including es14 tablishing a time period for family members of 

15 an individual who has died by suicide to enroll 

16 in coverage or change coverage, and effective 

17 date of such coverage.’’. 

18 (d) FEDERAL EMPLOYEES’ HEALTH BENEFITS PRO19 GRAM.—The requirements imposed by the amendments 

20 made by subsections (a), (b), and (c) of this section shall 

21 apply to any plan provided under the Federal Employees’ 

22 Health Benefits Program (chapter 89 of title 5, United 

23 States Code). 


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1 (e) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply with respect to plan years begin3 ning after the date of enactment. 

4 SEC. 4. OUTPATIENT MENTAL HEALTH SERVICES. 

5 Subpart 3 of part B of title V of the Public Health 

6 Service Act is amended by inserting after section 520E– 

7 4 (42 U.S.C. 290bb–36d) the following new section: 

8 ‘‘SEC. 520E–5 OUTPATIENT MENTAL HEALTH SERVICES. 

9 ‘‘(a) IN GENERAL.—The Secretary, acting through 

10 the Assistant Secretary for Mental Health and Substance 

11 Use, shall award grants to medical providers, hospitals, 

12 clinics, not-for-profit organizations, and religious organi13 zations, to provide outpatient mental health services for 

14 individuals impacted by the attempted or completed sui15 cide of a friend or family member. 

16 ‘‘(b) TRANSFER OF FUNDS.—Of the unobligated bal17 ance of the amount appropriated under section 4002 of 

18 the Patient Protection and Affordable Care Act, the Sec19 retary shall transfer $6,000,000 to carry out this section. 

20 ‘‘(c) REPORT.—Not later than 2 years after the date 

21 of enactment, the Secretary shall submit a report to Con22 gress on the implementation of this section. 

23 ‘‘(d) OUTPATIENT MENTAL HEALTH SERVICES.—In 

24 this section, the term ‘outpatient mental health services’ 

25 includes each of the following services: 


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1 ‘‘(1) Short-term counseling. 

2 ‘‘(2) Referral services. 

3 ‘‘(3) Follow-up services.’’. 

Æ 


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