The Disaster Relief Medicaid Act creates a new pathway for individuals affected by major disasters or emergencies to receive Medicaid assistance, effective for disasters declared on or after January 1, 2027. This legislation aims to ensure that survivors have access to crucial medical care during their recovery period. It introduces a new section, 1949, to Title XIX of the Social Security Act, outlining the specific provisions for disaster relief Medicaid. A "relief-eligible survivor" is defined as an individual whose family income does not exceed 133% (or 200% for pregnant individuals, children, or those with disabilities) of the poverty line, or the state's existing income eligibility standard. Importantly, unemployment compensation and FEMA individual assistance grants are disregarded when calculating income for eligibility. A "survivor" includes residents or evacuees from a disaster's direct impact area, as well as individuals who lost employment due to the disaster. The bill establishes a "relief coverage period" of two years, beginning on the date a disaster is declared. During this period, individuals determined to be relief-eligible survivors will receive continuous eligibility for medical assistance without the need for redetermination, subject to certain exceptions like voluntary termination or fraud. Pregnant and postpartum individuals, as well as those with pending applications for other Medicaid or CHIP programs, receive extended continuous eligibility. To streamline access, states are authorized to use a simplified, streamlined application form that relies on self-attestation for survivor status and need for home and community-based services (HCBS), without requiring additional documentation. The bill also mandates presumptive eligibility, allowing qualified providers to immediately enroll individuals for a temporary period while their full application is processed. States must issue a Disaster Relief Medicaid eligibility card to approved applicants. The scope of coverage for relief-eligible survivors must be at least equal to standard Medicaid benefits. For survivors receiving care in a state that is not their home state, the providing state must cover services available in the survivor's home state and pay providers at the home state's rate. The bill also provides for retroactive coverage, starting from the first day of the relief coverage period, and ensures children born to relief-eligible survivors are automatically eligible for Medicaid. States are given the option to provide enhanced services, including extended mental health and care coordination services , without typical restrictions on amount, duration, or scope. Additionally, states can offer home and community-based services to survivors who self-attest to needing them, including those who previously received such services or support from family caregivers. The Secretary is mandated to waive certain limitations on HCBS waivers to facilitate this provision. A significant financial incentive for states is the provision of 100% federal matching payments (FMAP) for medical assistance and administrative costs related to relief-eligible survivors. This 100% FMAP also applies to all Medicaid and CHIP services provided to individuals residing in a disaster's direct impact area during the relief coverage period. Furthermore, states are not required to conduct eligibility redeterminations for residents of direct impact areas during this time. The bill also directs the Secretary of Health and Human Services to issue guidance on best practices for expediting provider approval and utilizing out-of-state providers after a disaster. It mandates technical assistance and support for states to develop innovative strategies for responding to increased demand for medical assistance. A new grant program is established to fund HCBS emergency response corps in up to five states, composed of various stakeholders to address the needs of survivors. Other provisions include amending the Social Security Act to allow the Secretary to consider areas with a significant number of evacuees as an "emergency area" for waiver purposes during national emergencies. It also excludes the disaster relief coverage period from the calculation of Medicare Part B late enrollment penalties. Finally, the Act requires an independent, multi-year evaluation of its impact on relief-eligible survivors, including individuals with disabilities and pregnant individuals, with interim and follow-up reports to Congress.