Medicaid’s Role in Public Emergencies and Health Crises

Prepared for the Robert Wood Johnson Foundation State Health Reform Assistance Network

When it comes to natural disasters and public health crises, it is not surprising—in fact, it is expected—that federal agencies such as the Federal Emergency Management Association (FEMA) and the Centers for Disease Control and Prevention step in and help the victims. While less known, the Medicaid program plays a similarly essential role in responding to public health emergencies.

Notably, Medicaid’s role as a disaster response tool is possible because of its financing structure. Medicaid’s current matching rate structures guarantees that the federal government will match state expenditures on eligible individuals, without limitation. This open-ended federal commitment is key to Medicaid’s ability to respond quickly to major disasters and health crises.

In the context of federal legislative proposals that would cap federal Medicaid funding to states in the form of a per capita cap or block grant, it is important to review the role that Medicaid has played in several high-profile disasters and explore whether Medicaid could respond to similar disasters under alternative financing models that limit federal funding to states.

In a new issue brief for the Robert Wood Johnson Foundation State Health Reform Assistance Network, Manatt Health describes Medicaid’s unique and critical role in responding to events, such as the opioid and HIV/AIDS epidemics; the 2001 World Trade Center attacks; the Flint, Michigan lead contamination crisis; and Hurricane Katrina.



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