[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6408 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 6408
To amend title XIX of the Social Security Act to establish a State
option to provide medical assistance to certain individuals with
serious mental illness or substance use disorder.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 3, 2025
Mr. Pfluger introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to establish a State
option to provide medical assistance to certain individuals with
serious mental illness or substance use disorder.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Access to New Community Health
Opportunities and Recovery Act of 2025'' or the ``ANCHOR Act of 2025''.
SEC. 2. ESTABLISHING A STATE OPTION TO PROVIDE MEDICAL ASSISTANCE TO
CERTAIN INDIVIDUALS WITH SERIOUS MENTAL ILLNESS OR
SUBSTANCE USE DISORDER.
Section 1902 of the Social Security Act (42 U.S.C. 1396a) is
amended--
(1) in subsection (a)(10)(A)(ii)--
(A) in subclause (XXII), by striking ``or'' at the
end;
(B) in subclause (XXIII), by adding ``or'' at the
end; and
(C) by adding at the end the following new
subclause:
``(XXIV) specified individuals (as
defined in paragraph (1) of subsection
(uu)), subject to the provisions of
such subsection;''; and
(2) by adding at the end the following new subsection:
``(uu) Specified Individuals.--
``(1) Definition.--For purposes of subsection
(a)(10)(A)(ii), the term `specified individual' means an
individual who--
``(A) is an uninsured individual (as defined in
subsection (ss));
``(B) whose income (as determined under subsection
(e)(14)) does not exceed 100 percent of the poverty
line (as defined in section 2110(c)(5)) applicable to a
family of the size involved;
``(C) who has been determined to have a qualifying
condition (as defined in paragraph (2)) by--
``(i) a health care provider; or
``(ii) an entity determined appropriate by
the State, which may include--
``(I) an emergency department;
``(II) a clinic certified by the
State as a certified community
behavioral health clinic in accordance
with the criteria described in section
223(a)(1) of the Protecting Access to
Medicare Act of 2014;
``(III) an entity that receives
funding from the State to provide
mental health or substance use disorder
services;
``(IV) an institution for mental
diseases (as defined in section
435.1010 of title 42, Code of Federal
Regulations (or a successor
regulation)); or
``(V) a State judicial, law
enforcement, or child welfare agency.
``(2) Qualifying condition defined.--For purposes of
paragraph (1)(C), the term `qualifying condition' means any of
the following:
``(A) Serious mental illness.
``(B) Serious emotional disturbance.
``(C) Opioid use disorder.
``(D) Stimulant use disorder (including with
respect to cocaine or methamphetamine).
``(3) Conditions.--
``(A) Scope.--Medical assistance shall be made
available to a specified individual in the same scope
and manner as such assistance is made available to
individuals described in subsection (a)(10)(A)(i).
``(B) Duration.--Medical assistance shall be made
available to a specified individual for an initial
continuous 1-year period. At the option of the State,
the State may extend the availability of such
assistance to such individual for subsequent continuous
1-year periods, provided that, prior to each such
extension, the State redetermines that such individual
continues to be a specified individual.
``(4) Ensuring quality of care.--A State shall, as a
condition of exercising the State's option to make medical
assistance available to specified individuals--
``(A) ensure such individuals have a care plan
developed within 60 days of enrolling for such
assistance by a physician, primary care provider,
emergency department, clinical practice or clinical
group practice, rural clinic, community health center,
certified community behavioral health clinic, or other
health care provider that is determined by the State to
be qualified to develop such a plan; and
``(B) agree to report the behavioral health
measures of the Core Set of Adult Health Care Quality
Measures for Medicaid with respect to such individuals
in accordance with section 1139B.''.
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