27 Million Lose Medicaid, Child Health Insurance Coverage After COVID-Era Protections End

Millions of Americans, including families with children, have lost access to Medicaid and the Children’s Health Insurance Program (CHIP) following the expiration of pandemic-era protections, according to a federal review. The report, issued by the Government Accountability Office (GAO), found that 27 million individuals—roughly one-third of those reviewed—were disenrolled between April 2023 and September 2024. The findings highlight wide differences between states and demographic groups, suggesting uneven impacts on coverage and access to care.

During the COVID-19 emergency, Congress temporarily increased federal funding and suspended routine eligibility checks for Medicaid and CHIP, ensuring continuous coverage for enrollees. When states resumed full eligibility redeterminations in 2023—a process known as “unwinding”—many recipients were removed from the rolls either because they were no longer eligible or failed to submit the necessary paperwork. Although national enrollment remained higher than before the pandemic, at approximately 79 million as of October 2024, the number dropped from a peak of 94 million in March 2023.

The rate of disenrollment varied sharply between states. In six states, fewer than 20% of individuals lost coverage, while 12 states reported rates exceeding 40%. The variation appears linked to how each state conducted the redetermination process and the extent of support provided to enrollees during the transition.

Certain populations were especially affected. Young adults, in particular, were disproportionately disenrolled, with federal officials suggesting many aged out of youth-specific eligibility groups and did not qualify under stricter adult eligibility rules. These trends raise concerns for coverage continuity, especially for those transitioning between eligibility groups without clear guidance.

Residents in states with higher disenrollment rates may face increased out-of-pocket healthcare costs or difficulty accessing medical care unless they find alternative coverage. Affected individuals are encouraged to contact their state’s Medicaid agency or healthcare marketplace to determine eligibility or explore other insurance options. States are expected to complete the redetermination process by the end of 2025.

Article by multiple contributors, based upon information from the U.S. Government Accountability Office press release GAO-25-107413

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