H.R. 6408

[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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