ANCHOR Act of 2025

On December 2, 2025, Senator Marsha Blackburn (R-TN) introduced S. 3300, the Access to New Community Health Opportunities and Recovery Act (ANCHOR Act). The bill amends Section 1902 of the Social Security Act to add a state option to provide Medicaid coverage to 'specified individuals' — uninsured adults with income at or below 100% of the federal poverty line who have been diagnosed with a qualifying condition: serious mental illness, serious emotional disturbance, opioid use disorder, or stimulant use disorder. The bill was read twice and referred to the Senate Committee on Finance. A companion identical bill (HR 6408) was introduced in the House and referred to the Energy and Commerce Committee. This is an early-stage authorization bill — it establishes a policy framework and eligibility expansion but does not itself appropriate funds. Actual coverage expansion requires each state to opt into this new eligibility group and the federal government to fund its share of Medicaid expansion costs (at standard FMAP rates). The bill does not specify a new funding stream or authorization amount; it simply creates the legal option under Title XIX. The money trail flows through traditional Medicaid financing: if states opt in, the federal government pays its standard medical assistance percentage (FMAP) for this newly covered population, ranging from 50% to 83% depending on the state. Managed care organizations contracted by those states receive per-member per-month capitation payments for these new enrollees. The bill specifically allows determination of qualifying condition by emergency departments, certified community behavioral health clinics, and state judicial/law enforcement agencies, broadening the access funnel beyond traditional primary care. Structural winners are Medicaid-focused managed care organizations with high exposure to states likely to opt in. Centene (CNC) and Molina (MOH) have the highest Medicaid concentration and are most leveraged to enrollment growth. UnitedHealth (UNH) and CVS (Aetna) benefit through their large Medicaid plans and ancillary service capabilities (Optum behavioral health, CVS Caremark PBM). Humana (HUM) has more modest Medicaid exposure but participates in several state contracts. Real market data shows significant upward movement in Medicaid MCO stocks over the past 30 days: CNC +54.91%, MOH +38.37%, HUM +35.86%, UNH +41.6%, CVS +15.55%. The 7-day trend accelerates further: CNC +27.33%, MOH +21.22%, HUM +5.67%. This price action substantially predates and overshadows any direct ANCHOR Act catalyst — the bill was introduced 5 months ago with no further legislative action since referral. The more likely driver is the broader positive regulatory environment for Medicaid managed care, including the April 18, 2026 Executive Order on accelerating treatments for serious mental illness, which signals administration support for expanding behavioral health access. Timeline: The ANCHOR Act remains at the earliest legislative stage. It requires committee hearings, markup, Senate floor vote, House passage, and Presidential signature. No committee actions have occurred since referral. The companion bill in the House is at a similarly early stage. Passage probability is moderate given bipartisan interest in mental health/SUD policy and a Republican lead sponsor, but the bill faces competition with many other healthcare priorities. A realistic timeframe for enactment, if it moves, is 2027 or later.