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.
Summary
SB3300, the ANCHOR Act of 2025, would amend Medicaid law under Title XIX of the Social Security Act to create a new state option to provide medical assistance to certain uninsured adults with serious behavioral health needs. To qualify, an individual must have income at or below 100% of the federal poverty line and be determined by a health care provider or another state-approved entity to have a qualifying condition, including serious mental illness, serious emotional disturbance, opioid use disorder, or stimulant use disorder such as cocaine or methamphetamine use disorder.
The bill allows states to cover these individuals for an initial continuous one-year period, with the option to renew coverage in additional one-year periods if the person still meets the eligibility criteria. Coverage would be provided in the same scope and manner as Medicaid assistance for other eligible groups, but states choosing this option would also have to ensure that enrollees receive a care plan within 60 days and that behavioral health quality measures are reported under Medicaid quality reporting requirements.
Impact
The bill would amend section 1902 of the Social Security Act to add a new Medicaid eligibility category for specified individuals with serious mental illness or substance use disorder. It would expand state flexibility by letting states opt in to cover uninsured, very low-income people with these conditions, while also imposing care-planning and quality-reporting conditions on participating states. The practical effect would be to broaden access to Medicaid-funded behavioral health treatment and related services for a targeted population, while leaving implementation to state choice.
Sentiment
Based on the bill text and available legislative history, the measure appears to be framed as a targeted access-to-care and recovery initiative rather than a broad Medicaid expansion. No committee transcript or vote record is available, so there is no recorded debate or roll-call sentiment to assess. The overall tone of the bill is policy-oriented and supportive of treatment access, care coordination, and behavioral health quality measurement.
Contention
The main potential points of contention are likely to be the Medicaid expansion implications, the use of a state option rather than a federal mandate, and the scope of eligible conditions and qualifying entities. States may differ on whether to adopt the option, and some may question the administrative burden of care-plan development and reporting requirements. Another possible issue is the inclusion of institutions for mental diseases and nontraditional screening entities such as emergency departments, law enforcement, and child welfare agencies in the eligibility determination process.