Disaster Relief Medicaid Act Guarantees 2 Years of Coverage and 100% Federal Funding for Major Disaster Survivors

Starting January 1, 2027, the Disaster Relief Medicaid Act creates a brand-new, temporary path for healthcare coverage for people hit by major disasters. The core idea is simple: if your home or job was in a federally declared disaster zone, you get access to Medicaid for two full years, and the federal government picks up the entire tab—100% of the medical and administrative costs. This is a massive change from the usual cost-sharing model between states and the feds.

The Two-Year Healthcare Safety Net

This bill defines a “survivor” as someone who lived in the disaster area or lost their job because their workplace was shut down by the event. To qualify for this special Disaster Relief Medicaid, your family income cannot exceed 133% of the federal poverty line. Crucially, the state must ignore any unemployment compensation or FEMA aid you received when calculating that income. This means the aid meant to help you rebuild won't disqualify you from getting necessary medical coverage. For instance, if you’re a construction worker whose house was destroyed, the FEMA check you get for temporary housing won't count against you when you apply for this healthcare.

Getting signed up is designed to be painless. States are required to use a simplified application process that relies heavily on “self-attestation.” You essentially swear that you meet the criteria, and the state can’t demand documentation to prove you’re a survivor or that you need certain home care services. Furthermore, qualified providers—like a doctor’s office—can grant you “presumptive eligibility” immediately, meaning you get care right away while your full application is processed. Once approved, you keep this coverage for the full two-year relief period, unless you move, die, or commit fraud. This stability is huge for people trying to rebuild their lives after losing everything.

What Happens When the Smoke Clears?

The bill also addresses a lot of the administrative headaches that pop up when people are displaced. If you’re a survivor who has to evacuate and ends up in another state, the state providing you care has to cover everything your home state’s Medicaid plan would have, and they must pay the providers at the rate your home state would have paid. This ensures that a nurse practitioner treating you in a neighboring state gets paid fairly and you don't lose access to necessary services, like extended mental health care or home and community-based services (HCBS), which states are encouraged to offer without the usual limits.

Beyond Medicaid, the bill offers two important buffers. First, it expands the Secretary of Health and Human Services’ (HHS) ability to waive requirements for receiving communities. This means if a town 500 miles away takes in thousands of evacuees, that town can also be treated as an “emergency area,” allowing its hospitals and clinics to quickly adapt to the sudden surge in patients. Second, if the disaster kept you from enrolling in Medicare Part B on time, the months you were covered under this disaster relief program won't count against you when calculating the late enrollment penalty. This is a smart fix for seniors who had bigger things to worry about than paperwork during a crisis.

New Grants for Home Care Response Teams

Recognizing that disasters hit vulnerable populations the hardest, the bill sets up a new $10 million annual grant program (running through 2032) to fund “Home and Community-Based Services (HCBS) emergency response corps” in up to five states that frequently receive evacuees. These teams are designed to quickly get essential home care services to older adults and people with disabilities who are displaced. The corps must include a mix of voluntary organizations, agencies on aging, and disability advocates, ensuring that the response is coordinated and comprehensive.

While the 100% federal funding is a major win for states—especially those frequently hit by hurricanes or wildfires—it’s worth noting the accountability measures. While states can’t require documentation from survivors, they are required to attempt to recover the full cost of medical assistance if someone knowingly lies on their application. This is the bill’s way of balancing rapid access with fraud prevention. Overall, this legislation is a focused effort to ensure that when a disaster hits, people's immediate need for healthcare doesn't get buried under bureaucratic red tape.