ANCHOR Act of 2025
Legislative Progress
In CommitteeMrs. Blackburn introduced the following bill; which was read twice …
Summary
What This Bill Does
The ANCHOR Act gives states the option to provide Medicaid coverage to uninsured adults with serious mental illness, substance use disorders (including opioid and stimulant addiction), or serious emotional disturbances who live at or below the poverty line. This addresses a gap where some of the most vulnerable people fall through the cracks of the healthcare system.
Who Benefits and How
Uninsured individuals with mental illness or addiction would gain access to Medicaid coverage for a minimum of one year, with potential extensions if states choose. Mental health providers, addiction treatment centers, and community behavioral health clinics would see new patient revenue as previously uninsured individuals become eligible for covered services. Hospitals and emergency rooms would benefit from reduced uncompensated care costs, as patients who previously had no coverage would now have Medicaid.
Who Bears the Burden and How
Federal taxpayers would fund the federal share of Medicaid costs for this new eligibility group through the Federal Medical Assistance Percentage (FMAP). State governments that choose to participate must pay their share of Medicaid costs and meet new requirements including developing care plans within 60 days and reporting on behavioral health quality measures. State Medicaid agencies face additional administrative work to implement eligibility determinations and quality reporting.
Key Provisions
- Creates a new optional Medicaid eligibility category for "specified individuals" - uninsured people with qualifying behavioral health conditions at or below 100% of the federal poverty line
- Qualifying conditions include: serious mental illness, serious emotional disturbance, opioid use disorder, and stimulant use disorder (cocaine or methamphetamine)
- Requires states to ensure enrollees receive a care plan within 60 days of enrollment
- Coverage must be provided for at least one continuous year, with optional state extensions
- States must report behavioral health quality measures to CMS
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Establishes a state option under Medicaid to provide medical assistance to uninsured individuals with serious mental illness, serious emotional disturbance, or substance use disorders (including opioid and stimulant use disorders) whose income is at or below 100% of the federal poverty line.
Policy Domains
Legislative Strategy
"Expand Medicaid eligibility through state option to cover a vulnerable population currently falling through the cracks - uninsured individuals with severe behavioral health conditions"
Likely Beneficiaries
- Uninsured individuals with serious mental illness or substance use disorders
- Mental health treatment providers and facilities
- Substance use disorder treatment providers
- Certified community behavioral health clinics
- Hospitals and emergency departments (reduced uncompensated care)
- State Medicaid programs (optional, with federal matching)
- Institutions for mental diseases (IMDs)
Likely Burden Bearers
- Federal government (increased Medicaid spending through FMAP)
- State governments opting in (state share of Medicaid costs)
- Taxpayers (funding the Medicaid expansion)
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_state"
- → State Medicaid agencies
- "specified_individual"
- → Uninsured individual with qualifying mental health or substance use condition at or below 100% FPL
Key Definitions
Terms defined in this bill
An individual who is uninsured, whose income does not exceed 100% of the poverty line, and who has been determined to have a qualifying condition by a health care provider or appropriate state entity
Serious mental illness, serious emotional disturbance, opioid use disorder, or stimulant use disorder (including cocaine or methamphetamine)
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology