Nearly 700,000 Americans Lose Health Care Coverage in 2025

Miami Herald

a day ago

Almost 700,000 Americans lost Medicaid coverage in one month at the start of this year, according to new enrollment data compiled by KFF.
The significant drop in Medicaid enrollment in January from December 2024 is part of a long-term trend amid the continuation of the federal program's "unwinding" process, which began after pandemic-era protections ended. Enrollment was still higher in January than it was in February 2020.
The data highlights the continued ripple effects of the Medicaid policy shift, with millions more likely to be affected in the months ahead-particularly low-income families, children, and older adults who rely on Medicaid for basic care access.
Health care experts and advocates warn that the unwinding process is opening large gaps in the U.S. health care system, with many falling through the cracks due to administrative barriers or lack of communication, not because they no longer qualify.
Data collected by KFF shows that from December 2024 to January 2025, Medicaid enrollment dropped by 669,938, bringing the total number of Americans enrolled in Medicaid to around 71.2 million.
While this number remains high, it reflects a steady monthly decline that began in 2023 when states resumed redeterminations, where they checked whether enrollees were still eligible for benefits.
The process had been paused during the COVID-19 public health emergency alongside an expansion to the federal protection available for vulnerable Americans with limited income and resources.
When those protections were lifted following the pandemic, millions faced the risk of being disenrolled-not just due to income changes, but because of paperwork errors, missed deadlines, or outdated contact information.
According to KFF's data, more than 16 million people have been disenrolled from Medicaid since the unwinding began in the spring of 2023.
An April 2024 survey by KFF of 1,227 U.S. adults who had Medicaid coverage in prior to April 1, 2023, found that 28 percent of former enrolees found other forms of health coverage, while 47 percent were eventually re-enrolled to Medicaid. Around a quarter of enrolees reported as remaining uninsured.
States like Montana, Tennessee and Colorado have seen some of the largest decreases in enrollment, with levels in January 2025 dropping below pre-pandemic levels.
William Schpero, assistant professor of population health sciences at Weill Cornell Medicine, told Newsweek: "This is evidence that we are likely still seeing the effects of the end of the continuous coverage provisions in place during the COVID-19 Public Health Emergency that paused redeterminations of Medicaid eligibility. During the 'unwinding' of continuous coverage through September 2024, close to 70 percent of those who lost coverage were disenrolled for purely procedural reasons-for example, they missed a required renewal form because of a change in address. Many of these people likely remained eligible for Medicaid."
He added: "It would be particularly concerning if procedural terminations continue to underlie the latest reported decreases in Medicaid enrollment. It suggests that states can be doing more to prevent avoidable losses of coverage. Research has estimated that a large portion of individuals who have lost Medicaid in recent months have become uninsured or experienced gaps in coverage. We have consistent evidence that loss of Medicaid coverage interrupts access to care - without coverage, people forgo visiting the doctor or taking their prescribed medications due to cost. Ultimately this will hurt health outcomes."
Kathleen Adams, professor of health policy and management at Emory University's Rollins School of Public Health, Georgia, told Newsweek: "We are always concerned with the loss of insurance coverage, especially among the lower income and vulnerable groups traditionally served by Medicaid. If these individuals are not able to find a source of other coverage such as Employer Sponsored Insurance (ESI) or through the subsidized exchanges, they will have lower access to needed health care, face higher costs if they obtain care and could impose costs on the health care system as they are forced to seek care in ERs or other publicly subsidized sources of care."
She added: "The unwinding has taken place over a year and as the report notes, Medicaid enrollment is still higher now than in the pre-pandemic period. It is also important to note the differences seen across states. Some states that had not expanded Medicaid under the ACA did so recently and many of them show the largest increases in enrollment from their pre-pandemic levels. Currently, the concerns with Medicaid enrollment are with the administration's proposed changes to Medicaid eligibility which some states are already seeking to implement."
Unless policies change, experts project that millions more Americans may lose health coverage through 2025, not just due to changes in eligibility requirements, but also because of bureaucratic hurdles.
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