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.