Medicaid / CHIP Enrollment
Down from 79 million; unwinding pushing people off rolls, not into coverage
What is the current Medicaid / CHIP Enrollment reading?
76.8 million Americans were enrolled in Medicaid as of December 2025, according to Centers for Medicare & Medicaid Services enrollment data. Medicaid is the government health insurance program for low-income families and individuals, and enrollment tracks how many Americans cannot afford private coverage. Enrollment surged during the pandemic and has since declined as continuous-enrollment protections expired and states resumed standard eligibility checks.
Medicaid and CHIP enrollment has moved down from its all-time high of 94 million in April 2023; current 76.8 million has not exceeded that peak. It remains above the pre-pandemic baseline after the largest public-insurance unwinding in U.S. history.
The Centers for Medicare and Medicaid Services publish monthly enrollment data for Medicaid and the Children's Health Insurance Program. Enrollment ballooned to 94 million in April 2023 under pandemic-era continuous coverage rules, which prevented states from dropping anyone from the rolls regardless of income changes. Once that protection ended, the unwinding began.
Millions of people have come off the rolls since then, but enrollment still sits above the October 2019 baseline of 71.4 million — meaning the pool of people who qualify for public health coverage because they cannot afford private insurance has grown across the cycle, not shrunk.
Research from KFF and Urban Institute has found that a majority of those disenrolled lost coverage for procedural reasons — missed paperwork, renewal notices sent to outdated addresses — rather than because their income rose above eligibility limits. Many of those people are likely still eligible and now uninsured.
Medicaid enrollment, medical debt, bill-paying difficulty, and Bankruptcy Filings are published from different sources and populations. A decline in enrollment establishes that fewer people were enrolled; it does not establish what debts they later incurred or whether they filed a bankruptcy case.
Explore Further
How has Medicaid / CHIP Enrollment changed over time?
Most affected counties
Counties with the highest safety net and buffer scores in the County Distress Index.
Explore all 3,144 counties →| Period | Value | YoY Change |
|---|---|---|
| Dec 2025 | 76.8M | -2.2M |
| Sep 2025 | 76.8M | — |
| Dec 2024 | 79M | -15M |
| Jun 2024 | 79M | — |
| Dec 2023 | 94M | +4M |
| Apr 2023 | 94M | — |
| Dec 2022 | 90M | +3.3M |
| Jul 2022 | 90M | — |
| Dec 2021 | 86.7M | +6.7M |
| Dec 2020 | 80M | +8.6M |
| Dec 2019 | 71.4M | — |
| Oct 2019 | 71.4M | — |
Frequently Asked Questions
How many Americans are on Medicaid?
76.8 million Americans were enrolled in Medicaid as of December 2025 — the joint federal-state health insurance program for low-income individuals and families, and the largest health insurance program in the country by enrollment.
Why did Medicaid enrollment change recently?
Enrollment surged during the pandemic because continuous-enrollment protections barred states from removing beneficiaries. When those protections expired, states began 'unwinding' their rolls — some enrollees no longer qualified, others lost coverage over administrative paperwork rather than an eligibility change.
Where does Medicaid enrollment data come from?
The Centers for Medicare & Medicaid Services (CMS) publishes state-by-state Medicaid and CHIP enrollment data, updated as states report their monthly counts.
Quick poll
Is this affecting you or your household?
Discussion
Get the numbers when they move.
New data drops, indicator updates, and ADI score changes — delivered when it matters. No spam.
or Create an Account for full access
Loading comments…