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HR 3990119th CongressIn Committee

Disaster Relief Medicaid Act

Introduced: Jun 12, 2025
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs

Disaster Relief Medicaid Act would create a new, federally funded pathway to provide Medicaid coverage to people affected by major disasters, national emergencies, or public health emergencies. Starting Jan 1, 2027, states would offer medical assistance to “relief-eligible survivors” during a relief coverage period (from the disaster declaration date through two years afterward). Eligibility is designed to be streamlined and rapid, using presumptive eligibility and a simplified application, with rules to exclude certain disaster-related income (like FEMA grants and short-term unemployment payments) from determining eligibility. The bill also emphasizes continuity of care for disaster survivors, allows retroactive coverage for items and services furnished early in the relief period, and requires states to issue a disaster relief Medicaid eligibility card. In addition to expanding coverage, the bill would provide 100% federal funding (FMAP) for disaster-related Medicaid and related CHIP expenditures in direct impact areas, and it would offer guidance and support to states to improve surge capacity and emergency response, including a new HCBS Emergency Response Corps Grant Program. The text also creates reporting requirements and anti-fraud provisions specific to this program.

Key Points

  • 1Creation of a new Disaster Relief Medicaid program (Section 1949) that requires states to cover relief-eligible disaster survivors during a relief coverage period (from disaster declaration date to two years after) with at least the same scope as the state’s normal Medicaid coverage, plus cross-state considerations for home-state benefits.
  • 2Eligibility and access features designed for speed and simplicity: a streamlined, simplified application; no documentation requirements; presumptive eligibility by qualified providers; continuous eligibility during the relief period (with limited exceptions); disaster relief eligibility cards; and a 90-day deadline to submit a full application after the relief period ends for retroactive coverage.
  • 3Income rules and exclusions: relief-eligible survivors have income limits set at the higher of 133% of the poverty line (or 200% for pregnant individuals, children, or disabled individuals) or the home-state eligibility standard; disaster-related unemployment income and FEMA individual assistance grants are disregarded for purposes of determining eligibility.
  • 4100% federal funding: during the relief coverage period, the federal government would cover 100% of the medical assistance costs for disaster relief survivors (FMAP), plus related administrative costs; CHIP and related territorial adjustments would also be affected to reflect this increased federal support.
  • 5State and provider support: the Secretary would issue guidance to speed provider enrollment after disasters and support innovative state strategies (including demonstrations) to meet increased demand; creation of HCBS Emergency Response Corps Grants to test and operate home- and community-based services for disaster survivors (up to 5 states, 2-year grants, $10 million per year, 2027–2032).

Impact Areas

Primary group/area affected- Relief-eligible survivors of major disasters, national emergencies, or public health emergencies who reside in direct impact areas and meet income tests during the relief coverage period; includes pregnant individuals, children, and people with disabilities who qualify under the higher income threshold.Secondary group/area affected- State Medicaid programs and their waivers, plus the Children’s Health Insurance Program (CHIP) in direct impact areas; states’ administrative systems and IT processes used to determine eligibility and issue disaster relief eligibility cards.Additional impacts- Healthcare providers (through presumptive eligibility and streamlined enrollment), emergency management agencies, and organizations serving older adults and people with disabilities via the HCBS Emergency Response Corps; potential temporary changes to provider payment rates and cross-state coverage arrangements; program integrity and fraud provisions specific to disaster relief applications; reporting requirements to Congress.
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