Medicaid Enrollment and Unwinding Tracker

Note: The data presented below are updated monthly as new Medicaid/CHIP enrollment data become available.

The Medicaid Enrollment and Unwinding Tracker presents the most recent data on monthly Medicaid/CHIP enrollment reported by the Centers for Medicare & Medicaid Services (CMS) as part of the Performance Indicator Project as well as archived data on renewal outcomes reported by states during the unwinding of the Medicaid continuous enrollment provision. The unwinding data were pulled from state websites, where available, and from CMS.

Medicaid/CHIP Enrollment Trends

Medicaid/CHIP enrollment trends generally use February 2020 as the baseline month because it was the month prior to the start of the COVID-19 pandemic and implementation of the continuous enrollment provision. During continuous enrollment, which was in place during the three years of the pandemic, states paused Medicaid disenrollments. As a result, when the continuous enrollment provision ended in March 2023, national Medicaid/CHIP enrollment had increased to a record high of 94 million enrollees. Beginning April 1, 2023, states could resume disenrolling people after conducting renewals to verify eligibility for the program, though some states delayed the start of their unwinding periods until May, June, or July 2023. Most states took 12 months to complete unwinding renewals, with all but four states (AK, DC, NC, and NY) completing unwinding renewals by August 2024.

The figures below show Medicaid and CHIP enrollment from February 2020 through the most current month of available data. Some figures also include enrollment for adults and children in Medicaid/CHIP. Key enrollment trends as of July 2024 include:

• There are 79.6 million people enrolled in Medicaid/CHIP nationally (Figure 1). This represents a 16% decline from total Medicaid/CHIP enrollment in March 2023, but still 11% higher than Medicaid/CHIP enrollment in February 2020, prior to the pandemic (Figure 2 and Table 1).
• Several factors likely explain why national Medicaid/CHIP enrollment is higher than pre-pandemic enrollment. The pandemic may have encouraged some people who were previously eligible for Medicaid but not enrolled to newly enroll in the program. During the unwinding, many states took steps to improve their renewal processes, which reduced the number of people who were disenrolled despite remaining eligible. In addition, some states expanded eligibility for certain groups since the start of the pandemic, such as the Affordable Care Act’s (ACA) Medicaid expansion.
• Medicaid/CHIP enrollment is higher than pre-pandemic levels in all but seven states (MT, CO, AR, TX, ID, IA, and TN). Enrollment changes from pre-pandemic baseline vary from an 11% decrease in Montana to a 54% increase in North Carolina (Figure 2). Many of the states with the largest increases in enrollment expanded eligibility since the start of the pandemic. For example, five states (NE, OK, MO, SD, and NC) implemented the Medicaid expansion between October 2020 and December 2023 and Maine increased the income limit for children to qualify for Medicaid.
• In the 49 states and DC with complete enrollment data by age, there are 36.8 million children (47%) and 40.8 million adults (53%) enrolled, a change from pre-pandemic (February 2020) enrollment patterns when children made up a slight majority (51%) of Medicaid/CHIP enrollees (Figure 1).
• Child enrollment in Medicaid/CHIP is below pre-pandemic enrollment in 13 states, while adult enrollment is below pre-pandemic levels in five states (Figure 2).
• There are 72.4 million people enrolled in Medicaid and 7.1 million people enrolled in CHIP (Figure 1). More states report Medicaid enrollment above their pre-pandemic baselines compared to the number reporting CHIP enrollment above the baseline (Figure 2).