Medicaid and CHIP in 2025: What Enrollment Data Shows — and What to Do If You Lost Coverage

If you're wondering whether Medicaid or the Children's Health Insurance Program (CHIP) may be available to your family, the data suggests it's worth checking — even if you were previously disenrolled. Monthly enrollment figures tracked by the Centers for Medicare & Medicaid Services (CMS) show that tens of millions of Americans remain covered, but also that a historic wave of disenrollments swept through 2023 and 2024 as pandemic-era protections expired. Many of those removed from Medicaid rolls may still meet income and household requirements and can reapply without a waiting period.

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Data Snapshot: Medicaid and CHIP Enrollment by the Numbers

According to CMS Medicaid & CHIP Enrollment Data (https://www.cms.gov/data-research/statistics-trends-and-reports/medicaid-chip-enrollment-data), total Medicaid and CHIP enrollment peaked at approximately 94.5 million people during the COVID-19 continuous enrollment period. As of early 2025, enrollment has declined to an estimated 79–81 million, reflecting the ongoing effects of the post-pandemic unwinding that began in April 2023.

During that unwinding, an estimated 25 million people were disenrolled nationwide. CMS data and independent analyses have consistently found that the majority of those terminations were procedural — meaning people lost coverage because renewal notices went to outdated addresses, paperwork was missed, or deadlines passed — not because they actually became ineligible.

For CHIP specifically, the program covers roughly 7–8 million children at any given time. Federal matching funds flow to states through the Department of Health and Human Services (HHS), with federal matching rates that can exceed 90 cents on the dollar for states with higher child poverty rates — making CHIP one of the most federally subsidized health programs in the country.

These figures matter for families trying to understand the landscape: the programs are large, actively funded, and designed to serve households in financial hardship. If you lost coverage in the past two years, the data strongly suggests you may be worth a second look.

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Who Medicaid and CHIP Are Designed to Serve

Medicaid: Income and Category Eligibility

Medicaid is a joint federal-state program. Each state administers its own version under federal guidelines set by CMS. Eligibility depends on income, household size, and in many cases, a qualifying category — such as being a parent or caretaker, pregnant, elderly, or living with a disability.

Under the Affordable Care Act (ACA) Medicaid expansion, adopted by most but not all states as of 2025, adults without dependent children may be eligible if household income is at or below 138% of the Federal Poverty Level (FPL). In states that have not expanded Medicaid, eligibility for non-disabled adults without children may be severely limited or effectively unavailable.

For families with children, pregnant individuals, and people with disabilities, income thresholds vary widely — generally ranging from roughly 100% to 200% of FPL depending on the category and the state. Some states set thresholds higher for specific groups, such as pregnant women or infants.

CHIP: Covering the Gap for Children

CHIP was created specifically to serve children in families who earn too much to qualify for Medicaid but cannot afford private insurance. Most states set CHIP income limits between 200% and 300% of FPL, and some states extend eligibility higher. A handful of states also use CHIP funds to cover pregnant women.

CHIP benefits typically include:

  • Routine well-child visits and immunizations
  • Dental and vision care
  • Emergency services
  • Prescription medications
  • Mental health and behavioral health services

Premiums and cost-sharing under CHIP are generally low. For families with income below 150% of FPL, most states charge no premiums at all. Benefit amounts vary by household size and income, and covered services differ by state.

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Why So Many People Were Disenrolled — and What You Can Do About It

During the COVID-19 pandemic, a federal continuous enrollment requirement prohibited states from removing anyone from Medicaid rolls, even if their circumstances changed. When Congress ended that protection in March 2023, states were required to conduct a full eligibility review of every enrollee — a process that came to be called the "unwinding."

The scale of what followed was unprecedented. Renewal notices went to addresses that were years out of date. Families who had moved, changed phone numbers, or simply never received paperwork were removed from coverage. In many states, the majority of disenrollments in the first months of unwinding were for procedural reasons, not actual ineligibility.

If you or a family member lost Medicaid or CHIP coverage during 2023 or 2024, there is no waiting period to reapply. You can submit a new application at any time. If your income and household situation hasn't changed significantly, you may find that coverage options are still available to you.

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Step-by-Step: How to Apply for Medicaid or CHIP

Step 1: Gather Your Documents

Having the right paperwork ready before you start can speed up the process significantly. Collect the following:

  • Proof of identity: Driver's license, state ID, or passport
  • Proof of residency: Utility bill, lease agreement, or bank statement showing your current address
  • Proof of income: Pay stubs from the last 30 days, an employer letter, or a tax return if self-employed
  • Social Security numbers: For all household members included in the application
  • Immigration documents: If applicable — green card, visa, or other status documentation
  • Proof of household size: Birth certificates for children or documentation of dependents

If you don't have all of these documents, apply anyway. Many state agencies will work with applicants to gather missing materials after submission rather than requiring everything upfront.

Step 2: Choose Your Application Method

Online: Apply through your state's Medicaid agency website or through HealthCare.gov, which screens for both Marketplace plans and Medicaid/CHIP eligibility at the same time.

By phone: Call your state Medicaid agency directly. Most maintain dedicated enrollment lines, often with extended hours.

In person: Visit your local Department of Social Services, county health department, or a Federally Qualified Health Center (FQHC). Many FQHCs have certified enrollment assisters on staff at no cost to you.

By mail: Most states still accept paper applications, though processing times tend to be longer than online submissions.

Note: If you submit a form or request assistance through any third-party service, you may be contacted by phone, email, or text. Review and understand any communication consent terms before submitting your information.

Step 3: Submit and Track Your Application

After submitting, you should receive a confirmation number or written notice. Federal rules generally require states to process standard Medicaid applications within 45 days, or 90 days if a disability determination is needed. CHIP applications are typically processed within 30 days.

If you are pregnant or facing an emergency medical situation, ask specifically about presumptive eligibility — a temporary coverage option available in many states that may provide coverage while your full application is under review.

Step 4: Respond to Requests Promptly

If your state agency requests additional documentation, respond as quickly as possible. Missing a deadline can result in a denial, though in most cases you can reapply immediately after a denial without a waiting period.

Step 5: Appeal If You're Denied

A denial is not necessarily the end of the road. Every denial notice must include instructions for filing an appeal and the applicable deadline — typically 90 days from the date of the notice. You have the right to request a fair hearing. In many states, free legal aid organizations can provide an advocate to assist you through the appeals process at no cost.

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State-by-State Variation: Why Your Location Matters

Because Medicaid and CHIP are state-administered programs, eligibility rules, covered services, and application processes differ significantly depending on where you live.

  • Expansion vs. non-expansion states: As of 2025, the majority of states have adopted ACA Medicaid expansion, but a small number have not. Adults without children or a qualifying disability in non-expansion states may find their options significantly more limited.
  • Income thresholds: Even within the same eligibility category — such as children or pregnant individuals — income limits vary from state to state.
  • Covered services: Federal law sets minimum benefit requirements, but states may offer additional services such as adult dental care, non-emergency medical transportation, or expanded behavioral health coverage.

Always verify current rules directly with your state Medicaid agency. Information changes, and state-specific details are the most reliable guide to what may be available where you live.

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Where to Get Free Help Navigating the Process

You don't have to figure this out alone. The following resources offer free, unbiased enrollment assistance:

  • Benefits.gov (https://www.benefits.gov): Helps you identify programs that may be available based on your household situation
  • HealthCare.gov: Screens for Medicaid and CHIP eligibility alongside subsidized Marketplace plans
  • Federally Qualified Health Centers (FQHCs): Provide care on a sliding-scale basis and often have certified enrollment assisters on-site
  • State Medicaid agencies: Your primary source for state-specific eligibility rules and application links
  • Legal aid organizations: Can assist if you've been denied coverage or need help navigating an appeal

None of these resources charge fees for enrollment assistance. Be cautious of any service that asks for payment to help you apply for Medicaid or CHIP.

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

Last reviewed: July 2025