I 
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 Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access to New Commu-
nity Health Opportunities and Recovery Act of 2025’’ or 
the ‘‘ANCHOR Act of 2025’’. 
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SEC. 2. ESTABLISHING A STATE OPTION TO PROVIDE MED-
ICAL ASSISTANCE TO CERTAIN INDIVIDUALS 
WITH SERIOUS MENTAL ILLNESS OR SUB-
STANCE 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 sub-
section: 
‘‘(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)); 
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‘‘(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 in-
volved; 
‘‘(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 behav-
ioral 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 dis-
order services; 
‘‘(IV) an institution for mental 
diseases 
(as 
defined 
in 
section 
435.1010 of title 42, Code of Federal 
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Regulations (or a successor regula-
tion)); or 
‘‘(V) a State judicial, law en-
forcement, 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 sub-
section (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 op-
tion of the State, the State may extend the 
availability of such assistance to such individual 
for subsequent continuous 1-year periods, pro-
vided that, prior to each such extension, the 
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