More Than a Million Americans Removed From Health Care Plan in One Month

Newsweek

4 days ago

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More than one million Americans lost health coverage in a single month at the end of last year as states continued to unwind pandemic-era coverage protections.
According to data published by KFF, a nonprofit health policy research and news organization, national enrollment in Medicaid and the Children's Health Insurance Program (CHIP) dropped from 79,569,888 in November 2024 to 78,532,341 in December 2024, a net loss of 1,037,547 enrollees.
Newsweek has contacted the Centers for Medicare & Medicaid Services (CMS) outside of regular hours via email for comment.
Why It Matters
The unwinding process has significantly reshaped Medicaid enrollment across the U.S. Under federal rules in place during the pandemic, states were required to keep most Medicaid recipients continuously enrolled, even if their eligibility status changed. That requirement expired in March 2023, allowing states to resume removing individuals from the program.
Since the unwinding began, enrollment has steadily declined, driven by both eligibility losses and procedural disenrollments—when individuals lose coverage due to missing paperwork or administrative errors rather than no longer qualifying.
File photo: Medicaid activists wait to enter the House Energy and Commerce.
File photo: Medicaid activists wait to enter the House Energy and Commerce.
Tom Williams/CQ Roll Call via AP
What To Know
The drop represents one of the many steep single-month declines recorded since states began redetermining eligibility in early 2023, following the end of the COVID-19 public health emergency declaration.
The December enrollment figure of 78.5 million is the lowest recorded figure since late 2020. For comparison, total Medicaid enrollment peaked at 94.6 million in April 2023, during the pandemic-era continuous coverage period.
State-by-state trends also show uneven disenrollment rates, with Utah reporting disenrollment rates as high as 31 percent between March 2023 and December 2024, followed by Texas with 30 percent, while South Dakota saw a 2 percent decrease in enrollment in the same time frame.
California, Maine, Alaska, Connecticut, and Oregon were other states that only saw a single-figure disenrollment rate during that time.
KFF reported that child enrollment in the two programs is now below pre-pandemic enrollment in 13 states, while adult enrollment is below pre-pandemic levels in 7 states.
Although, while in some states' disenrollment happened rapidly, returning to enrollment rates matching the early 2020 numbers, national Medicaid and CHIP enrollment is not yet back to pre-pandemic levels.
What People Are Saying
Eileen Sullivan-Marx, dean and professor of New York University Rory Meyers College of Nursing, told Newsweek: "It would be hard to know what caused this one month decline, however, it does reinforce that there is a projected trend downward continuing. It could be that some of the state differentials that month are skewing the whole data downward between November and December. I also notice that this is mostly a steeper downward trend for adults. The tendencies presently occurring have to do with disenrollments and the difficulty to re-enroll once disenrolled. If states do not make sure that there is a smooth way to re-enroll or enroll on a regular basis then there could be sharper decline in those enrolled in Medicaid."
She added: "Disenrollments that are occurring simply because it is hard to re-enroll have consequences for those who need coverage in terms of accessing health care, getting medications, having to pay privately for a nursing home stay."
Ben Anderson, the deputy senior director of health policy at Families USA, a health care-focused consumer advocacy group, told KFF in September: "We have seen some amazing coverage expansion in places like Oregon and California. But if you live in Texas, Florida, and Georgia, since the pandemic your health coverage has been disrupted in ways that were preventable by state leaders."
What Happens Next
As the unwinding continues, more reductions in enrollment are expected. With millions already having lost health coverage, concerns remain about access to care for low-income individuals and families.