There are 2 million fewer children enrolled in either Medicaid or the Children’s Health Insurance Program compared to January 2025, according to a new report.
The Children and Families at Georgetown University’s McCourt School of Public Policy operates a state-by-state enrollment tracker that identified the declines through April, and warned that enrollment drop-offs at this scale should alarm policymakers. Federal data finds a 4% decline, equating to about 1.5 million children, per the report.
In a blog post, Joan Alker, the center’s executive director and a research professor at Georgetown, compares the coverage declines to trends from President Donald Trump’s first term. The child uninsured rate increased from 4.7% in 2026, a historic low, to 5.7% by 2019.
The COVID-19 recovery response stabilized child coverage, she wrote, but when those guarantees ended, there was an increase in the number of children without insurance.
In a snapshot of Trump’s first term, from December 2017 to December 2018, 828,000 children dropped out of Medicaid and CHIP, indicating that coverage decreases are happening more rapidly in the president’s second term, Alker said.
The finding, she wrote, “is ominous since Medicaid cuts from H.R. 1 have largely not even kicked in yet.”
Over the next several months, states will be tasked with rolling out a significant number of changes to their Medicaid programs, which come alongside funding cuts and changes. The Congressional Budget Office projected in May that 3 million children would drop out of Medicaid over the decade, and the report does not account for changes in CHIP enrollment.
Alker wrote that policymakers should make a concerted effort to identify the source of the coverage losses and address them quickly to “reverse a disaster in the making.”