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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.
Summary
This bill would allow states to provide Medicaid medical assistance to uninsured individuals with serious mental illness, serious emotional disturbance, or opioid or stimulant use disorders, provided their income does not exceed 100 percent of the federal poverty line. The qualifying condition must be determined by a health care provider, emergency department, mental health clinic, or other entity designated by the state. Eligible individuals would receive Medicaid coverage for an initial one-year period, which states could extend for additional years, and states must ensure these individuals have a care plan developed within 60 days of enrollment and must report specified behavioral health quality measures.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
Money behind the sponsor
Top reported contributors to August Pfluger’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for August Pfluger → · Outside spending →
Actions (2)
- Dec 3, 2025 Referred to the House Committee on Energy and Commerce. · house
- Dec 3, 2025 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
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.”. <all>
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