I 
119TH CONGRESS 
1ST SESSION H. R. 3990 
To provide Medicaid assistance to individuals and families affected by a 
disaster or emergency, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 12, 2025 
Mr. PANETTA (for himself and Ms. TOKUDA) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To provide Medicaid assistance to individuals and families 
affected by a disaster or emergency, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Disaster Relief Med-
icaid Act’’. 
SEC. 2. MEDICAID RELIEF FOR DISASTER SURVIVORS. 
Title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) is amended— 
(1) in section 1902(a)— 
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(A) in paragraph (86), by striking ‘‘; and’’ 
and inserting a semicolon; 
(B) in paragraph (87), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (87) the 
following new paragraph: 
‘‘(88) beginning January 1, 2027, provide for 
making medical assistance available to relief-eligible 
survivors of disasters during relief coverage periods 
in accordance with section 1949.’’; and 
(2) by adding at the end the following new sec-
tion: 
‘‘SEC. 1949. DISASTER RELIEF MEDICAID FOR SURVIVORS 
OF MAJOR DISASTERS. 
‘‘(a) IN GENERAL.—Notwithstanding any other pro-
vision of this title, a State plan shall provide medical as-
sistance to a relief-eligible survivor of a disaster in accord-
ance with this section. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) DISASTER.—The term ‘disaster’ means 
any of the following: 
‘‘(A) A major disaster that is declared on 
or after January 1, 2027, by the President in 
accordance with section 401 of the Robert T. 
Stafford Disaster Relief and Emergency Assist-
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ance Act (42 U.S.C. 5170) and which the 
President has determined warrants individual 
or public assistance from the Federal Govern-
ment under such Act. 
‘‘(B) A national emergency declared by the 
President under the National Emergencies Act 
(50 U.S.C. 1601 et seq.). 
‘‘(C) A public health emergency declared 
by the Secretary pursuant to section 319 of the 
Public Health Service Act (42 U.S.C. 247d). 
‘‘(2) DIRECT IMPACT AREA.— 
‘‘(A) IN GENERAL.—The term ‘direct im-
pact area’ means, with respect to a disaster, the 
geographic area in which the disaster exists. 
‘‘(B) WEBSITE
POSTING
OF
DIRECT
IM-
PACT AREAS.—As soon as practicable after a 
disaster is declared (as described in subpara-
graph (A), (B), or (C) of paragraph (1), as ap-
plicable), the Secretary shall post on the 
websites of the Centers for Medicare & Med-
icaid Services and the Federal Emergency Man-
agement Agency a list of the areas identified as 
the direct impact areas of the disaster. 
‘‘(3) HOME
STATE.—The term ‘home State’ 
means, with respect to a survivor of a disaster, the 
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State in which the survivor was a resident (as deter-
mined in accordance with section 435.403 of title 
42, Code of Federal Regulations (or any successor 
regulation)) on the date on which the disaster is de-
clared (as described in subparagraph (A), (B), or 
(C) of paragraph (1), as applicable). 
‘‘(4) RELIEF
COVERAGE
PERIOD.—The term 
‘relief coverage period’ means, with respect to a dis-
aster, the period that begins on the date the disaster 
is declared (as described in subparagraph (A), (B), 
or (C) of paragraph (1), as applicable) and ends on 
the day that is 2 years after such date. 
‘‘(5) RELIEF-ELIGIBLE SURVIVOR.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (C), the term ‘relief-eligible survivor’ 
means an individual who is a survivor of a dis-
aster whose family income does not exceed the 
higher of— 
‘‘(i) 133 percent (or, in the case of a 
survivor who is a pregnant individual, a 
child, or a recipient of benefits under title 
II on the basis of a disability, 200 percent) 
of the poverty line; or 
‘‘(ii) the income eligibility standard 
that would otherwise apply to the survivor 
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under the State plan of the survivor’s 
home State (or a waiver of such plan). 
‘‘(B) DISREGARD OF UNEMPLOYMENT IN-
COME
AND
FEMA
INDIVIDUAL
ASSISTANCE 
GRANTS.—For purposes of this section, and 
notwithstanding section 1902(e)(14)(B), the in-
come of a survivor of a disaster shall not in-
clude— 
‘‘(i) any amount received by the sur-
vivor during the relief coverage period of 
the disaster under a law of the United 
States or a State which is in the nature of 
unemployment compensation; or 
‘‘(ii) any amount received during the 
relief coverage period of the disaster by the 
survivor (or the survivor’s household) as 
assistance under a program administered 
by the Federal Emergency Management 
Agency. 
‘‘(C) LIMITATION
TO
RELIEF
COVERAGE 
PERIOD.— 
‘‘(i) IN
GENERAL.—Except as pro-
vided in clauses (ii) and (iii), for purposes 
of this section, an individual shall not be 
considered to be a relief-eligible survivor on 
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the basis of the individual’s status as a 
survivor of a disaster after the end of the 
relief coverage period of the disaster. 
‘‘(ii) CONTINUOUS
ELIGIBILITY
FOR 
DISASTER
RELIEF
COVERAGE
FOR
PREG-
NANT AND POSTPARTUM INDIVIDUALS.—In 
the case of an individual who, while preg-
nant, receives medical assistance as a re-
lief-eligible survivor of a disaster under a 
State plan (or a waiver of such a plan) in 
accordance with this section, such indi-
vidual shall continue to be eligible for med-
ical assistance as a relief-eligible survivor 
through the end of the month in which the 
60-day period (beginning on the last day of 
the pregnancy) (or, if longer, the period of 
postpartum continuous eligibility that oth-
erwise applies to individuals who, while 
pregnant, are eligible for medical assist-
ance under the State plan or waiver) ends, 
without regard to whether the pregnancy 
ends before or after the end of the relief 
coverage period of the disaster. 
‘‘(iii) CONTINUOUS
ELIGIBILITY
FOR 
INDIVIDUALS
WITH
PENDING
APPLICA-
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TIONS.—If an individual who receives med-
ical assistance as a relief-eligible survivor 
of a disaster under a State plan (or a 
waiver of such a plan) in accordance with 
this section has an application pending for 
medical assistance under the State plan (or 
waiver) under this title or for child health 
assistance or pregnancy-related assistance 
under a State plan under title XXI (or a 
waiver of such a plan) on the date that the 
relief coverage period of the disaster ends, 
such individual shall continue to be eligible 
for medical assistance as a relief-eligible 
survivor through the earlier of— 
‘‘(I) the end of the month in 
which the 60-day period (beginning on 
the last day of such relief coverage pe-
riod) ends; and 
‘‘(II) the date on which the indi-
vidual’s application for medical assist-
ance, child health assistance, or preg-
nancy-related assistance (as applica-
ble) is approved or denied. 
‘‘(6) SURVIVOR.— 
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‘‘(A) IN
GENERAL.—The term ‘survivor’ 
means, with respect to a disaster, an individual 
who is described in subparagraph (B) or (C). 
‘‘(B) RESIDENTS AND EVACUEES OF DI-
RECT IMPACT AREAS.—An individual described 
in this subparagraph is an individual who, on 
the date on which a disaster is declared (as de-
scribed in subparagraph (A), (B), or (C) of 
paragraph (1), as applicable), has a primary 
residence in the disaster’s direct impact area. 
‘‘(C) INDIVIDUALS
WHO
LOST
EMPLOY-
MENT.—An individual described in this sub-
paragraph is an individual— 
‘‘(i) whose worksite was located in the 
disaster’s direct impact area; 
‘‘(ii) who was employed by an em-
ployer that— 
‘‘(I) conducted an active trade or 
business in such area on the date on 
which the disaster was declared (as so 
described); and 
‘‘(II) was unable to operate such 
trade or business as a result of the 
disaster on any day during the disas-
ter’s relief coverage period; and 
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‘‘(iii) whose employment with such 
employer was terminated. 
‘‘(D) TREATMENT
OF
HOMELESS
PER-
SONS.—In the case of an individual who is 
homeless (as such term is defined in section 
103(a) of the McKinney-Vento Homeless As-
sistance Act (42 U.S.C. 11302(a))) on the date 
on which a disaster is declared (as so de-
scribed), the individual’s residency for purposes 
of subparagraph (B) shall be determined in ac-
cordance with section 435.403 of title 42, Code 
of Federal Regulations (or any successor regu-
lation). 
‘‘(E) EFFECT
OF
CONCURRENT
ELIGI-
BILITY FOR MEDICAID OR CHIP.—An individ-
ual’s eligibility for medical assistance under a 
State plan (or waiver of such plan) (or for child 
health assistance or pregnancy-related assist-
ance under a State plan under title XXI (or a 
waiver of such a plan)) on a basis other than 
under this section shall not prevent the indi-
vidual from being treated as a survivor under 
this section, and the rights afforded to an indi-
vidual who is eligible for or enrolled under a 
State plan (or waiver) under either such title 
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shall not be affected by the individual’s receipt 
of medical assistance as a relief-eligible survivor 
of a disaster in accordance with this section. 
‘‘(c) ELIGIBILITY.— 
‘‘(1) SIMPLIFIED APPLICATION.— 
‘‘(A) IN GENERAL.—For purposes of deter-
mining eligibility for medical assistance under 
this section, each State may accept a simplified, 
streamlined application form (as developed by 
the Secretary in consultation with the National 
Association of State Medicaid Directors), which 
shall— 
‘‘(i) require an applicant for medical 
assistance in accordance with this section 
as a survivor of a disaster to— 
‘‘(I) provide the applicant’s mail-
ing address for the duration of the re-
lief coverage period of the disaster; 
and 
‘‘(II) agree to update the infor-
mation described in subclause (I) if it 
changes during such period; 
‘‘(ii) provide notice of the penalties for 
making a fraudulent application described 
in subsection (g); 
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‘‘(iii) require the applicant to assign 
to the State any rights of the applicant (or 
any other individual who is a relief-eligible 
survivor and on whose behalf the applicant 
has the legal authority to execute an as-
signment of such rights) as described and 
in accordance with the requirements of sec-
tion 1912; 
‘‘(iv) require the applicant to list any 
health insurance coverage in which the ap-
plicant was enrolled immediately prior to 
submitting the application for medical as-
sistance under this section; and 
‘‘(v) require the applicant to self-at-
test that the applicant— 
‘‘(I) is a relief-eligible survivor of 
the disaster; and 
‘‘(II) if applicable, requires home 
and community-based services. 
‘‘(B) 
NO
DOCUMENTATION
REQUIRE-
MENT.— 
‘‘(i) IN GENERAL.—A State shall not 
require an applicant for medical assistance 
as a survivor of a disaster under this sec-
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tion to provide any documentation or other 
evidence— 
‘‘(I) of the applicant’s status as a 
relief-eligible survivor; and 
‘‘(II) if applicable, that the appli-
cant requires home and community- 
based services. 
‘‘(ii) USE OF AVAILABLE ELECTRONIC 
DATA
SOURCES.—In making determina-
tions with respect to the status of an appli-
cant for medical assistance as a survivor of 
a disaster under this section, or such an 
applicant’s need for home and community- 
based services, a State may use data relat-
ing to the applicant that is available to the 
State from electronic data sources. 
‘‘(2) PRESUMPTIVE ELIGIBILITY FOR RELIEF- 
ELIGIBLE SURVIVORS.— 
‘‘(A) IN GENERAL.—A State shall provide 
for making medical assistance available to an 
individual as a relief-eligible survivor under this 
section during a presumptive eligibility period. 
‘‘(B) PRESUMPTIVE
ELIGIBILITY
PERIOD 
DEFINED.—For purposes of this paragraph— 
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‘‘(i) the term ‘presumptive eligibility 
period’ means, with respect to an indi-
vidual, the period that— 
‘‘(I) begins with the date on 
which a qualified provider determines, 
on the basis of preliminary informa-
tion, that the individual satisfies the 
criteria for eligibility for medical as-
sistance as a relief-eligible survivor 
under this section; and 
‘‘(II) ends with (and includes) 
the earlier of— 
‘‘(aa) the day on which a de-
termination is made with respect 
to the eligibility of the individual 
for medical assistance as a relief- 
eligible survivor under this sec-
tion; or 
‘‘(bb) in the case of an indi-
vidual who does not file an appli-
cation by the last day of the 
month following the month dur-
ing which the provider makes the 
determination referred to in item 
(aa), such last day; and 
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‘‘(ii) the term ‘qualified provider’ has 
the meaning given such term in section 
1920. 
‘‘(C) COORDINATION
BETWEEN
STATE 
AGENCIES AND QUALIFIED PROVIDERS.— 
‘‘(i) PROVISION
OF
FORMS
AND
IN-
FORMATION TO QUALIFIED PROVIDERS.— 
The State agency shall provide qualified 
providers with— 
‘‘(I) such forms as are necessary 
for an individual to make application 
for medical assistance under the State 
plan as a relief-eligible survivor; and 
‘‘(II) information on how to as-
sist individuals and their authorized 
representatives in completing and fil-
ing such forms. 
‘‘(ii) PROVISION OF NOTICE OF DE-
TERMINATIONS
TO
STATE
AGENCIES.—A 
qualified provider that determines under 
this subparagraph that an individual is eli-
gible for medical assistance under a State 
plan as a relief-eligible survivor under this 
section shall— 
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‘‘(I) notify the State agency of 
the determination within 5 working 
days after the date on which deter-
mination is made; and 
‘‘(II) inform the individual at the 
time the determination is made that 
the individual is required to make ap-
plication for medical assistance under 
the State plan by not later than the 
last day of the month following the 
month during which the determination 
is made. 
‘‘(D) APPLICATION
REQUIREMENT.—An 
individual who is determined by a qualified pro-
vider to be presumptively eligible as a relief-eli-
gible survivor for medical assistance under a 
State plan shall make application for medical 
assistance under such plan by not later than 
the last day of the month following the month 
during which the determination is made, which 
application may be the streamlined application 
described in paragraph (1). 
‘‘(E) TREATMENT
AS
MEDICAL
ASSIST-
ANCE.—Notwithstanding any other provision of 
this title, items and services that are— 
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‘‘(i) furnished to an individual during 
a presumptive eligibility period under this 
paragraph by a provider that is eligible for 
payments under the State plan; and 
‘‘(ii) included in the care and services 
covered by the State plan; 
shall be treated as medical assistance provided 
to a relief-eligible survivor of a disaster during 
the relief coverage period of the disaster under 
this section. 
‘‘(3) CONTINUOUS ELIGIBILITY.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), an individual who is determined by 
a State to be a relief-eligible survivor of a dis-
aster shall remain eligible for medical assistance 
under the State plan (or a waiver of such plan) 
as such a survivor, without the need for any re-
determination of eligibility, for the duration of 
the relief coverage period of the disaster. 
‘‘(B) EXCEPTIONS.—A State may termi-
nate the eligibility of an individual who is deter-
mined by a State to be a relief-eligible survivor 
of a disaster before the end of the relief cov-
erage period of the disaster if— 
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