Disaster Relief Medicaid Act
Disaster Relief Medicaid Act creates a new, disaster-specific pathway within Medicaid (Title XIX) to provide medical assistance to people affected by major disasters, national emergencies, or public health emergencies. Starting in 2027, states would offer “Disaster Relief Medicaid” to relief-eligible survivors for a relief coverage period of up to two years, with the option to extend coverage for certain groups (e.g., pregnant individuals) and for related services like home-and-community-based services (HCBS) and extended mental health care. The program is designed to be fully funded by the federal government during the relief period (100% FMAP) for benefits and certain administrative costs, with rapid and streamlined eligibility processes, presumptive eligibility, and continuous eligibility during the relief period. The bill also directs specific guidance to states on increasing provider access, supports a grant program to strengthen HCBS responses, and extends targeted 100% FMAP treatment to disaster-affected direct impact areas (including CHIP). If enacted, this would substantially expand and standardize Medicaid relief coverage for disaster survivors across states.
Key Points
- 1Establishes a new disaster-relief pathway (Section 1949) to provide medical assistance to relief-eligible survivors during a “relief coverage period” (start date of disaster through 2 years after) for major disasters, national emergencies, or public health emergencies declared by the President or Secretary of HHS.
- 2Eligibility and income rules for relief-eligible survivors:
- 3- Thresholds: income up to the higher of 133% of the federal poverty line (or 200% for pregnant individuals, children, or people with disabilities) or the home-state standard.
- 4- Income not counted during relief (excludes unemployment benefits and FEMA individual assistance grants).
- 5- Continuous eligibility during the relief period, with limited exceptions (voluntary termination, moving out of state, fraud, or death); pregnancy-related continuous eligibility extends beyond the relief period.
- 6- Streamlined, no-documentation required enrollment, presumptive eligibility by qualified providers, and an expedited “disaster relief Medicaid” eligibility card.
- 7- Semantics of relief eligibility related to direct impact areas and home-state coordination (out-of-state items covered at home-state rates when appropriate).
- 8Benefits and scope:
- 9- Provides at least as much coverage as would be available under the state plan for an eligible person, plus certain home-state services when applicable.
- 10- Optional home-and-community-based services (HCBS) and extended mental health and care coordination benefits, with authority to waive certain waiver restrictions to address disaster needs.
- 11- Retroactive coverage from the first day of the relief period for those who apply by a deadline (90 days after the end of the relief period).
- 12- Special rules for pregnant/postpartum eligibility and for children born to relief-eligible survivors.
- 13- Disaster-relief eligibility card and a focus on rapid enrollment through an express-lane eligibility process.
- 14Federal financing and incentives:
- 15- 100% FMAP (federal medical assistance percentage) for disaster-relief medical costs and certain related administrative costs during the relief period.
- 16- Exemption from certain caps and penalties for these disaster-related payments, and provisions to support states with the administrative burden of disaster response.
- 17State and federal support for rapid response and innovation:
- 18- Secretary must issue guidance to states on expediting provider enrollment after disasters and using out-of-state providers when needed.
- 19- Technical assistance and a program to create HCBS emergency response corps (up to 5 states, grants for two-year terms, $10 million/year, 2027-2032) to bolster home- and community-based care for disaster survivors.
- 20Targeted relief for direct impact areas:
- 21- 100% FMAP for all medical assistance provided in disaster direct impact areas during the disaster relief period.
- 22- Applies to territories and to CHIP direct-impact assistance, with corresponding adjustments to CHIP allotments to reflect the higher federal match.