ANCHOR Act of 2025

This legislation amends the Social Security Act to create a new state option for providing medical assistance under Medicaid. This option targets specified individuals who are uninsured, have an income at or below 100 percent of the federal poverty line, and have been diagnosed with a qualifying condition. Qualifying conditions include serious mental illness , serious emotional disturbance, opioid use disorder, or stimulant use disorder. These conditions can be determined by a healthcare provider or various state-approved entities, such as emergency departments or certified community behavioral health clinics. Medical assistance for these individuals will be provided with the same scope as standard Medicaid benefits for an initial continuous one-year period, with states having the option to extend coverage annually after re-evaluating eligibility. To exercise this state option, states must ensure that enrolled individuals receive a comprehensive care plan developed by a qualified provider within 60 days of enrollment. Additionally, participating states are required to report on specific behavioral health measures from the Core Set of Adult Health Care Quality Measures for Medicaid, ensuring accountability and quality of care.