2 Million Children Dropped From Medicaid and CHIP Since January 2025

If your child recently lost Medicaid or Children's Health Insurance Program (CHIP) coverage, you are not alone — and losing coverage does not automatically mean your child no longer qualifies. Since January 2025, an estimated 2 million children across the United States have been disenrolled from Medicaid or CHIP, according to reporting from Fierce Healthcare. Many of these losses are tied to administrative issues — outdated addresses, missed renewal notices, or processing backlogs — rather than actual changes in family income or household circumstances. Understanding why this is happening, and what steps you can take right now, may help your family find a path back to coverage.

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Data Snapshot

As of the most recent federal data available, Medicaid and CHIP together covered approximately 77 million Americans, with children making up the single largest group of enrollees. CHIP alone covered roughly 7.2 million children in fiscal year 2023, according to the Centers for Medicare & Medicaid Services (CMS) at https://www.medicaid.gov/chip/index.html. Income eligibility thresholds for CHIP vary by state but typically range from 200% to 300% of the Federal Poverty Level (FPL) — meaning a family of four earning up to roughly 2 to 3 times the federal poverty guideline may still be eligible depending on where they live. In some states, CHIP eligibility extends even higher. The scale of the 2 million disenrollments since January 2025 represents a significant share of the program's child enrollee base and underscores the urgency for affected families to act.

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Why Are So Many Children Losing Coverage?

The disenrollments happening in 2025 are connected to a process called Medicaid unwinding and ongoing eligibility redeterminations. During the COVID-19 public health emergency, states were required to keep people continuously enrolled in Medicaid. When that protection ended in 2023, states began reviewing eligibility for all enrollees — a process that has continued into 2025 and created significant administrative strain.

Common reasons children are being dropped include:

  • Outdated contact information — renewal notices sent to old addresses go unanswered
  • Paperwork not returned on time — families may not realize a renewal form was required
  • Procedural disenrollments — some children are removed for administrative reasons even when they remain income-eligible
  • System errors — state Medicaid agencies have reported data and processing errors during the redetermination process
  • Income changes not properly reviewed — some families are dropped without a full review of their current financial situation

If your child was recently disenrolled, the first question to ask is: why? The reason matters because it determines your fastest path back to coverage.

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What Is CHIP and Who May Be Eligible?

The Children's Health Insurance Program (CHIP) is a federally funded, state-administered program that provides low-cost health coverage to children in families who earn too much to qualify for Medicaid but may not be able to afford private insurance.

General CHIP Eligibility Guidelines

  • Age: Typically covers children from birth through age 18 (some states cover up to age 19)
  • Income: Generally available to families with household income between 100% and 300% of the Federal Poverty Level (FPL), though this varies significantly by state
  • Citizenship/Immigration status: U.S. citizens and certain qualified immigrants are generally eligible; some states have expanded coverage to additional groups
  • Insurance status: Most states require that the child not currently have access to affordable employer-sponsored insurance, though rules vary

Because CHIP is state-administered, eligibility thresholds, covered services, and cost-sharing requirements differ from state to state. A child who does not qualify in one state might qualify in another.

What CHIP Typically Covers

  • Well-child visits and preventive care
  • Immunizations and vaccines
  • Doctor and specialist visits
  • Prescription medications
  • Dental and vision care
  • Emergency services
  • Mental health and behavioral health services

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Step-by-Step: What to Do If Your Child Lost Coverage

Step 1: Find Out Why Your Child Was Disenrolled

Contact your state Medicaid or CHIP agency directly. Ask for a written explanation of why your child's coverage ended. If the disenrollment was due to a paperwork issue or administrative error, you may be able to request reinstatement without starting a new application.

Step 2: Gather Your Documents

Whether you are appealing a disenrollment or submitting a new application, you will likely need:

  • Proof of identity for the child (birth certificate, passport)
  • Proof of your household income (recent pay stubs, tax returns, employer letters)
  • Proof of residency (utility bill, lease agreement, or official mail)
  • Social Security numbers for the child and applying parent or guardian
  • Proof of citizenship or immigration status
  • Current health insurance information, if any

Having these documents ready before you contact your state agency or apply online can significantly speed up the process.

Step 3: Request an Appeal If You Believe the Disenrollment Was an Error

You have the right to appeal a Medicaid or CHIP disenrollment decision. States are required to provide a fair hearing process. When you receive a notice of disenrollment, it should include information about how to appeal and the deadline to do so — typically 90 days from the date of the notice, though this varies by state. Do not miss this window.

Step 4: Reapply Through Your State Agency or HealthCare.gov

If your child is not eligible for Medicaid or CHIP, or if there is a gap while you wait for reinstatement, you may be able to enroll in a subsidized Marketplace health plan through HealthCare.gov (or your state's own exchange). Losing Medicaid or CHIP coverage qualifies as a life event that triggers a Special Enrollment Period (SEP), giving you 60 days from the date of coverage loss to enroll in a Marketplace plan.

Step 5: Ask About Retroactive Coverage

In some states, Medicaid can be applied retroactively — meaning if your child received medical care during a gap in coverage, Medicaid may cover those bills once coverage is restored. Ask your state agency whether retroactive coverage applies in your situation.

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How to Find Your State's Medicaid and CHIP Agency

Each state runs its own Medicaid and CHIP program under different names. To find your state's specific agency, application portal, and contact information:

Many states also allow you to apply for Medicaid and CHIP through HealthCare.gov, which will automatically screen your application for both programs.

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Realistic Timeline: What to Expect

  • Reinstatement after an administrative error: Can sometimes be resolved within days to a few weeks, depending on your state's processing capacity
  • New CHIP or Medicaid application: Most states are required to process children's Medicaid and CHIP applications within 45 days (or faster in some states)
  • Marketplace Special Enrollment Period: Coverage can begin as soon as the first of the month after you enroll, in most cases
  • Appeal process: Timelines vary, but states must schedule a fair hearing and issue a decision within a reasonable period — typically 30 to 90 days

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A Note on Navigators and Enrollment Assisters

If the application or appeal process feels overwhelming, free help is available. Certified Application Counselors (CACs) and Navigators are trained, federally funded helpers who can walk you through the process at no cost to you. You can find a Navigator near you at https://localhelp.healthcare.gov.

Community health centers, legal aid organizations, and many nonprofit social service agencies also offer free enrollment assistance.

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People Also Ask

Q: Can my child reapply for CHIP after being dropped? Yes. Being disenrolled does not permanently bar a child from CHIP. If your child still meets your state's income and eligibility requirements, you can reapply at any time through your state Medicaid agency or HealthCare.gov. If the disenrollment was due to a paperwork issue, you may also be able to request reinstatement rather than starting a new application.

Q: What income level qualifies a child for CHIP? CHIP income limits vary by state but generally cover families earning between 200% and 300% of the Federal Poverty Level (FPL). Some states set the threshold higher. Because FPL guidelines change annually and state rules differ, check your specific state's current limits through Medicaid.gov or Benefits.gov for the most accurate figures.

Q: What if my child needs medical care right now but has no coverage? Federally Qualified Health Centers (FQHCs) provide care on a sliding-fee scale regardless of insurance status. Find one near you at findahealthcenter.hrsa.gov. You should also contact your state Medicaid agency immediately — in some states, emergency Medicaid coverage may be available, and retroactive coverage may apply once your child is re-enrolled.

Q: How long does a CHIP or Medicaid appeal take? Appeal timelines vary by state, but most states are required to schedule a fair hearing and issue a written decision within 30 to 90 days of your request. During the appeal, you may be able to request that your child's coverage continue while the decision is pending — ask your state agency about this option when you file.

Q: Is there a deadline to appeal a Medicaid or CHIP disenrollment? Yes. Most states require you to file an appeal within 90 days of the date on your disenrollment notice, though some states have shorter windows. Read your notice carefully and act as quickly as possible. Missing the appeal deadline may require you to submit a new application instead.

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

Last reviewed: July 2026