2 Million Children Have Lost Medicaid Coverage Since Early 2025

If your child was recently dropped from Medicaid or CHIP — or if you haven't received a renewal notice and aren't sure whether coverage is still active — you're not alone. A report from Georgetown University's Center for Children and Families found that approximately 2 million fewer children were enrolled in Medicaid since the start of 2025. Understanding what happened, why it happened, and what you can do about it is the most practical place to start.

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Data Snapshot

According to Georgetown University's Center for Children and Families, total Medicaid and CHIP enrollment for children fell by roughly 2 million between January 2025 and the time of the report's publication. This follows the end of the continuous enrollment protections that were in place during the COVID-19 public health emergency — protections that had kept millions of children covered even if their household circumstances changed. Prior to the unwinding period, the Centers for Medicare & Medicaid Services (CMS) reported that more than 40 million children were enrolled in Medicaid and CHIP nationally (source: CMS Medicaid Enrollment Data, cms.gov). The drop represents a significant reversal of coverage gains made over the previous five years. Benefit amounts and program structures vary by state; for current enrollment data by state, visit https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html.

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Why Are Children Losing Medicaid Coverage?

The coverage losses are tied to several overlapping policy and administrative factors:

The End of Continuous Enrollment Protections

During the COVID-19 pandemic, a federal rule prevented states from disenrolling anyone from Medicaid, even if their income or household situation changed. That protection ended in 2023, and states began conducting what's called "Medicaid unwinding" — reviewing eligibility for every enrolled person. That process has continued into 2025 and has resulted in millions of disenrollments, many of them due to administrative reasons rather than actual ineligibility.

Administrative Disenrollments

Many children are being dropped not because their family's income increased, but because: - A renewal form was sent to an outdated address - The family didn't respond to a renewal notice in time - Required documents weren't submitted before a deadline - A state system error flagged the case incorrectly

This is a critical point: a disenrollment notice does not always mean your child is no longer eligible. It may simply mean the paperwork didn't get processed correctly.

Policy-Level Changes

Beyond the unwinding process, the Georgetown report points to federal-level policy shifts under the current administration that have affected how states administer Medicaid. Some states have implemented more frequent eligibility checks or tightened documentation requirements, which can create additional barriers for families who are still within income limits.

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Who May Still Be Eligible for Medicaid or CHIP?

Eligibility rules differ by state, but here are the general federal guidelines:

Medicaid for Children - Children under age 19 in households with income at or below 138% of the Federal Poverty Level (FPL) are generally eligible for Medicaid in states that expanded coverage. - In non-expansion states, income thresholds for children's Medicaid vary but are often set between 100%–138% FPL. - Infants (under age 1) often have higher income thresholds — up to 185% FPL or more in many states.

CHIP (Children's Health Insurance Program) - CHIP is designed for children whose families earn too much for Medicaid but can't afford private insurance. - Most states cover children in households earning between 138% and 200%–300% FPL, depending on the state. - Some states extend CHIP eligibility up to 400% FPL. - CHIP covers routine checkups, immunizations, dental care, vision, emergency services, and prescriptions.

No Waiting Periods for Most Children - Federal law generally prohibits states from imposing waiting periods on children applying for CHIP if they were previously uninsured — though some exceptions apply.

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Documents You'll Likely Need to Reapply

Gathering these before you start the application can speed up the process significantly:

  • Proof of identity for the child (birth certificate, hospital record, or passport)
  • Proof of citizenship or immigration status (U.S. birth certificate, U.S. passport, or immigration documents)
  • Proof of state residency (utility bill, lease agreement, or official mail with your address)
  • Proof of household income (recent pay stubs, tax return, or employer letter — for all adults in the household)
  • Social Security numbers for the child and, in most cases, the applying parent or guardian
  • Current health insurance information, if any (even if the child is uninsured, note that)
  • Any prior Medicaid or CHIP case numbers, if available

If you're missing documents, don't let that stop you from applying. Many state agencies will allow you to submit what you have and provide missing documents later.

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Step-by-Step: How to Check Coverage Status and Reapply

Step 1: Check Your Child's Current Enrollment Status Contact your state Medicaid agency directly. You can find your state's agency contact information at Medicaid.gov or through Benefits.gov. Have your child's Social Security number and date of birth ready.

Step 2: Review Any Notices You've Received If you received a termination or renewal notice, read it carefully. It will include: - The reason for the action - A deadline to respond or appeal - Instructions for submitting documentation

Step 3: File an Appeal If You Disagree If your child was disenrolled and you believe it was an error — or that your child still meets income requirements — you have the right to appeal. In most states: - You must file the appeal within 90 days of the notice date (some states allow less time, so act quickly) - You can request a fair hearing with your state Medicaid agency - In many states, your child's coverage may continue during the appeals process if you appeal before the termination date

Step 4: Reapply Online, by Phone, or In Person Even if the appeal window has passed, you can reapply at any time. Options typically include: - Online: Through your state's Medicaid portal or HealthCare.gov (for CHIP) - By phone: Call your state Medicaid agency or 1-877-KIDS-NOW (1-877-543-7669) for CHIP information - In person: At your local Department of Social Services or community health center - By mail: Download and mail a paper application from your state agency's website

Step 5: Ask About Retroactive Coverage If your child had a medical expense during the gap in coverage, ask whether your state offers retroactive Medicaid. Federal rules allow states to cover medical costs up to 3 months before the application date if the child was eligible during that time.

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If Your Child Doesn't Qualify for Medicaid or CHIP

If your household income is above the CHIP threshold in your state, there are still options worth exploring:

  • Marketplace plans through HealthCare.gov: Children can be enrolled in a Marketplace plan, and premium tax credits may significantly reduce costs for qualifying households.
  • Community health centers: Federally Qualified Health Centers (FQHCs) provide care on a sliding-fee scale regardless of insurance status. Find one at findahealthcenter.hrsa.gov.
  • Free and charitable clinics: Many communities have clinics that serve uninsured children at no cost.
  • Hospital financial assistance programs: Most nonprofit hospitals are required to offer charity care. Ask the billing department about financial assistance before paying any bill.

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A Note on State Variation

Medicaid and CHIP are jointly funded by the federal government and individual states, but each state administers its own program. Income thresholds, application processes, renewal timelines, and available benefits can differ significantly from one state to another. What's true in Texas may not apply in California or Ohio. Always verify the specific rules with your state Medicaid agency.

Program eligibility and availability vary by state. Not affiliated with any government agency.

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People Also Ask

Can I reapply for Medicaid after my child was disenrolled? Yes. Families may reapply for Medicaid or CHIP at any time, regardless of why coverage ended. There is no penalty or waiting period for reapplying. If your child meets current income and residency requirements, the application will be reviewed on its merits. Contact your state Medicaid agency or visit Benefits.gov to find your state's application portal.

How long does it take to get Medicaid approved for a child? Most states are required to process children's Medicaid applications within 45 days. CHIP applications must generally be processed within 45 days as well. Some states process applications faster. If you haven't heard back within 30 days, follow up with your state agency directly.

What if my child needs medical care right now and doesn't have coverage? Federally Qualified Health Centers (FQHCs) provide care on a sliding-fee scale and cannot turn away patients based on ability to pay. Find a nearby center at findahealthcenter.hrsa.gov. Hospital emergency rooms are also required by federal law to provide stabilizing care regardless of insurance status.

Does my immigration status affect my child's Medicaid eligibility? Children who are U.S. citizens or lawfully present immigrants may be eligible for Medicaid or CHIP regardless of their parents' immigration status. Some states have also extended coverage to certain undocumented children using state-only funds. Eligibility rules vary significantly by state, so check with your state Medicaid agency for specifics.

What is the income limit for CHIP? CHIP income limits vary by state but generally cover children in households earning between 138% and 300% of the Federal Poverty Level (FPL). Some states extend coverage up to 400% FPL. Because FPL thresholds are updated annually and state rules differ, check your state's specific limits at insurekidsnow.gov or Benefits.gov.

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Last reviewed: July 2026