Soon after taking office, President Trump reversed longstanding policy that had protected against immigration enforcement in “sensitive locations” including health care facilities, schools, and places of worship. Following this recission, as well as an overall increase in enforcement activity, there have been reports of Immigration and Customs Enforcement (ICE) agents showing up at hospitals and other health care facilities. ICE presence at and around health care facilities has led to growing concerns among health care providers about the impacts on the health and safety of the community, including adults and children going without care. These actions sit against a backdrop of broad increased enforcement activity and policies restricting access to health coverage and care for immigrant families. Research shows that this environment has negative impacts on the mental and physical health of immigrant families, including the millions of U.S. citizen children living in them, as well as broader economic effects on communities.

KFF has conducted multiple surveys examining immigrants’ health and experiences amid the policy environment as part of its Surveys of Immigrants conducted since 2023. New data from the KFF Health Tracking Poll provides insights into how the general public views the Trump administration’s immigration enforcement polices in health care settings. Overall, it shows the public is split along partisan lines on the administration’s approach to immigration enforcement in health care facilities. Democrats and independents express concern over the administration’s tactics, whereas Republicans are largely not concerned. Majorities of Democrats and independents say they do not think ICE or Customs and Border Control (CBP) should be allowed to arrest or detain people in and around health care facilities, whereas a majority of Republicans say they should be allowed. On each of these measures, Republicans and Republican-leaning independents who support President Trump’s MAGA movement are much more likely to support these tactics or say they are not concerned than non-MAGA supporters.

A majority of the public say they are concerned about the Trump administration’s tactics and immigration enforcement activities in or around health care settings. This includes majorities of the public who say they are “very” or “somewhat” concerned about people who have been hospitalized after being detained by federal immigration officials not being allowed to contact their families (69%), ICE or CBP arresting or detaining people in health care settings (63%), and health care providers and officials sharing patients’ immigration status with ICE or CBP (59%).

While majorities of the public are concerned about each of these tactics, there are big differences by partisanship, with Democrats and independents more likely than Republicans, especially MAGA Republicans, to say they are concerned about these. For example, about nine in ten Democrats and three-quarters of independents say they are concerned about people who have been hospitalized after detainment not being allowed to contact their families, whereas four in ten Republicans express concern. There are larger divides by partisanship on the two other tactics asked about, with Democrats about three times as likely as Republicans to say they are concerned about ICE or CBP detaining people in or around hospitals, clinics, or other health care facilities (92% vs. 28%) and health officials, hospitals, or health care providers sharing patients’ immigration status with ICE or CBP (86% vs. 24%). For each of these immigration enforcement tactics, two-thirds or more of independents say they are “very” or “somewhat” concerned about them. There are also differences among Republicans and Republican-leaning independents who support MAGA versus those who do not support the MAGA movement, with non-MAGA supporters at least twice as likely to say they are concerned about these tactics than MAGA supporters.

A majority of the public (56%) says ICE and CBP should not be allowed to arrest and detain people in or around hospitals, doctors’ offices or health clinics where they are seeking care, while about three in ten (28%) say they should be allowed, and one in six (16%) are “not sure.” There are stark divides by partisanship on this tactic. Nearly nine in ten (86%) Democrats and about six in ten (59%) independents say immigration enforcement activity should not be allowed in or around health care facilities, whereas six in ten Republicans say it should be allowed. But again among Republicans on this question, MAGA supporters are much more likely than non-MAGA supporters to say this tactic should be allowed (71% vs. 32%), and four in ten (41%) non-MAGA Republicans say it should not be allowed.

Two-thirds (65%) of adults say they are concerned that immigration enforcement activities in or around health care facilities may discourage some people from seeking needed medical care, while a third (34%) say they are not concerned. There are large differences by party identification on this topic, with about nine in ten Democrats (91%) and about seven in ten (69%) independents saying they are concerned about this, including three-quarters (76%) of Democrats who say they are “very concerned.” In contrast, most (65%) Republican say they are not concerned about this, including four in ten (41%) who say they are “not at all concerned.” However, there are stark divides by MAGA support among Republicans, with a majority of MAGA Republicans (76%) saying they are not concerned and a majority of non-MAGA Republicans (58%) saying they are concerned. Since the rescission of the “sensitive areas” policy and ramp up of ICE activity across the country, there have been reports of immigrants avoiding seeking medical care, which can lead to negative and costly health outcomes. Even prior to the recent uptick in public enforcement activity in areas such as Minneapolis and other parts of the country, the 2025 KFF/New York Times Survey of Immigrants found that many immigrants said they were avoiding seeking medical care due to concerns about drawing attention to someone’s immigration status. As of Fall 2025, 14% of immigrants overall said they have avoided seeking medical care since January 2025, rising to nearly half (48%) of likely undocumented immigrants.

This KFF Health Tracking Poll/KFF Tracking Poll on Health Information and Trust was designed and analyzed by public opinion researchers at KFF. The survey was conducted February 24 – March 2, 2026, online and by telephone among a nationally representative sample of 1,343 U.S. adults in English (n=1,268) and in Spanish (n=75). The sample includes 1,019 adults (n=62 in Spanish) reached through the SSRS Opinion Panel either online (n=995) or over the phone (n=24). The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to three reminder emails.

Another 324 (n=13 in Spanish) adults were reached through random digit dial telephone sample of prepaid cell phone numbers obtained through MSG. Phone numbers used for the prepaid cell phone component were randomly generated from a cell phone sampling frame with disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity groups within each frame. Among this prepaid cell phone component, 142 were interviewed by phone and 182 were invited to the web survey via short message service (SMS).

Respondents in the prepaid cell phone sample who were interviewed by phone received a $15 incentive via a check received by mail or an electronic gift card incentive. Respondents in the prepaid cell phone sample reached via SMS received a $10 electronic gift card incentive. SSRS Opinion Panel respondents received a $5 electronic gift card incentive (some harder-to-reach groups received a $10 electronic gift card). In order to ensure data quality, cases were removed if they failed two or more quality checks: (1) attention check questions in the online version of the questionnaire, (2) had over 30% item non-response, or (3) had a length less than one quarter of the mean length by mode. Based on this criterion, 1 case was removed.

The combined cell phone and panel samples were weighted to match the sample’s demographics to the national U.S. adult population using data from the Census Bureau’s 2024 Current Population Survey (CPS), September 2023 Volunteering and Civic Life Supplement data from the CPS, and the 2025 KFF Benchmarking Survey with ABS and prepaid cell phone samples. The demographic variables included in weighting for the general population sample are gender, age, education, race/ethnicity, region, civic engagement, frequency of internet use and political party identification. The weights account for differences in the probability of selection for each sample type (prepaid cell phone and panel). This includes adjustment for the sample design and geographic stratification of the cell phone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available on request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. KFF public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

This data note summarizes KFF polling on the U.S. public’s experiences with prescription drug costs, use of GLP-1 medications, and support for policy solutions. Key takeaways include:

• Most U.S. adults take at least one prescription drug, and many struggle or worry about affording their prescription medications. Six in ten adults say they are worried about being able to afford their prescription drug costs, a new high since KFF began asking in 2018. Four in ten say they have had to take cost-saving measures, such as skipping doses, not filling prescriptions, or taking other measures due to costs.
• Increasing use of GLP-1 medications raises particular cost concerns. About one in five adults have ever taken a GLP-1 medication, and most users – including those with health insurance – say these drugs are difficult to afford. KFF will continue to monitor the public’s experiences with GLP-1 medications as use, regulation, and new formulations – including oral versions – continue to evolve.
• Large majorities across party lines want the government to do more to regulate drug prices, and many support a range of policies. At least two-thirds of Democrats, independents, and Republicans say there is not enough regulation of prescription drug prices. Most support a range of policies to address costs, such as two provisions of the 2022 Inflation Reduction Act (IRA): allowing Medicare to negotiate prices and limiting how much drug companies can increase the price of drugs based on annual inflation rates.
• The Trump administration has taken several steps to try to lower prescription drug costs in its second term, but these initiatives have limited public visibility so far. Few adults have heard much about the administration’s drug pricing deals with manufacturers or TrumpRx, the federal website that provides discount coupons for certain drugs, launched in early 2026. KFF polling from 2019 found broad support for a related approach – lowering what Medicare pays for some drugs based on amounts in other countries – suggesting the idea has public appeal even if awareness of the current initiatives and the debates around them remain low.

Prescription drugs touch the lives of most people in the U.S. in some way, and the public broadly recognizes their benefits. About two-thirds (66%) of adults say they are currently taking at least one prescription drug, and three in ten (31%) say they currently take four or more prescription medications. While many adults across age groups take prescription medications, older adults are much more likely to report taking 4 or more medications.

Six in ten adults ages 65 and older report taking four or more prescription medications, compared to fewer than half of younger adults.

The public generally sees the benefits of these medicines. About six in ten (63%) adults believe prescription drugs developed over the past 20 years have generally made the lives of people in the U.S. better, while much smaller shares (21%) say they’ve made them worse or have not made a difference (15%).

Despite seeing their general benefits to society, about eight in ten adults (82%) say the cost of prescription drugs is unreasonable, and the public sees profits made by pharmaceutical companies as the largest factor contributing to these prices. More than three-quarters of adults across partisanship say profits made by pharmaceutical companies are a “major factor” in the price of prescription drugs. This is followed by more than half who say the cost of research and development is a “major factor” contributing to the price, and 45% saying the same about the cost of marketing and advertising.

Many Americans face significant challenges affording their medications, including adults who take more medications or have lower incomes. KFF polling shows these challenges have grown more acute over the years. While about two-thirds (65%) of adults overall say it is “very” or “somewhat” easy to afford their prescription drug costs, affordability is a bigger issue for those who are currently taking four or more prescription medicines. Nearly four in ten (37%) of those taking four or more prescription drugs say they have difficulty affording their prescriptions, compared with one in five (18%) adults who currently take three or fewer prescription medications. Adults with an annual household income of less than $40,000 are also more likely than adults with higher incomes to report difficulty affording their prescription medications.

Overall, about six in ten adults say they are worried about being able to afford prescription drug costs for themselves or their families (59%), including about one in five (22%) who are “very worried.” Worry varies by insurance status, household income, race, and ethnicity. Substantial shares of uninsured adults under age 65 (32%), Hispanic adults (30%), Black adults (26%), and adults in households with annual incomes less than $40,000 (27%) say they are “very worried” about affording their prescription drug costs.

Among adults who take four or more prescription medications, about two-thirds (64%) report worrying about affording their medications, including about three in ten (29%) who are “very worried.” However, worry is not limited to those who take at least four medications. Most adults who take fewer prescriptions (1 to 3) worry about being able to afford their medications (56%). Even among adults who do not currently take any prescriptions themselves, a majority (57%) are “very” or “somewhat worried” about affording prescription medications, perhaps reflecting concerns about future needs or the prescription drug costs of family members.

Notably, about one in five (19%) Medicare enrollees say they are “very worried” about affording their prescription drug costs. Although older adults are more likely to take more prescription medications than younger adults, the vast majority of Medicare beneficiaries are enrolled in Medicare Part D plans, giving them prescription drug coverage that has improved with recent policies in the Inflation Reduction Act of 2022.

About one in four (24%) Medicaid enrollees under age 65 say they are “very worried” about affording their prescription drug costs. Medicaid provides comprehensive access to prescription drugs for eligible adults, with out-of-pocket costs limited to nominal amounts, which helps adults avoid cost-related prescription medication rationing or delays. However, while prescription out-of-pocket costs in Medicaid are limited, even low amounts may still be prohibitive for low-income families with Medicaid.

Since KFF first asked about worries affording prescription drug costs in 2018, the share of adults reporting worries has increased steadily, to a new high of six in ten (59%) in 2026.

About four in ten (43%) adults report that they have not taken their medication as prescribed at some point in the past year because of the cost. This includes three in ten who have taken an over-the-counter drug instead (31%), a quarter who have not filled a prescription (27%), and about one in five (19%) who have cut pills in half or skipped doses of medicine because of the cost.

The share who reports not filling a prescription, taking an over-the-counter drug instead, or cutting pills in half or skipping doses increases to about half among adults with annual household incomes less than $40,000 (52%).

In recent years, KFF has been tracking the public’s use and experiences with GLP-1 medications. These medications, such as semaglutide or tirzepatide, are used for weight loss or managing chronic health conditions. As GLP-1 medications have expanded beyond their original use for treating Type 2 diabetes, their popularity, combined with their high cost and need for long-term use, poses a potential cost burden on consumers, employers, and insurers. In response, some employers have restricted or dropped coverage for weight loss in 2026. Medicare Part D currently covers GLP-1 drugs only when prescribed to treat chronic illnesses such as diabetes and sleep apnea but prohibits the coverage for weight loss alone under federal law. Under the Medicaid Drug Rebate Program (MDRP), state Medicaid programs must cover GLP-1s for conditions like diabetes, but coverage for obesity is optional under federal law.

As of March 2026, KFF Health Tracking Polls show about one in five adults have ever taken a GLP-1 medication (18%), including 12% who currently take this class of medication (an increase of 6 percentage points from May 2024).

While most GLP-1 users get their medications from a primary care doctor and have them at least partially covered by insurance, a majority, including 55% of those who have health insurance, say it is difficult to afford these drugs. KFF will continue to monitor the public’s experiences with GLP-1 medications as use, regulation, and new formulations – including oral versions – continue to evolve.

There is broad, bipartisan agreement that there should be more government regulation when it comes to prescription drug costs. The March 2026 KFF Health Tracking Poll finds about seven in ten adults (72%) say there is “not as much regulation as there should be” when it comes to limiting the price of prescription drugs, including at least two-thirds of Democrats (77%), Republicans (68%), and independents (72%).

Notably, larger shares of adults now say there is not enough regulation than five years ago, though KFF has found bipartisan agreement on this attitude since 2015.

For decades, lawmakers have debated and passed drug pricing legislation. For example, in 2022 the Inflation Reduction Act, or IRA, included several provisions aimed at lowering prescription drug costs. The public largely supports many of these provisions, including limiting how much drug companies can increase the price of drugs based on annual inflation rates (88%) and allowing the federal government to negotiate with drug companies to get a lower price on medications for people with Medicare (85%).

KFF polling shows the public – across partisans – is also supportive of other policy proposals that have been debated but not been put into law, such as increasing taxes on drug companies that refuse to negotiate the price of their drugs with the government, allowing Americans to buy drugs imported from Canada, making it easier for generic drugs to come to market, and expanding the IRA’s annual out-of-pocket maximum and monthly cap on insulin prices beyond people with Medicare.

It is also notable that bipartisan support for the IRA provisions has held since its passage, and majorities across partisan lines support expanding what the law currently does. KFF polling from 2024, during the Biden administration, showed that at least eight in ten (85%) U.S. adults supported authorizing the federal government to negotiate drug prices for people with Medicare as the IRA does. This provision was supported by 90% of Democrats, 87% of independents, and 79% of Republicans.

In 2024, majorities across partisanship also supported expanding two IRA provisions beyond those covered by Medicare. Three in four adults supported a proposal to expand the $35 cap on out-of-pocket costs for insulin beyond those with Medicare, including majorities of Democrats (82%), independents (78%), and Republicans (67%). About two-thirds supported a proposal to expand the $2,000 annual limit on out-of-pocket prescription drug costs beyond those with Medicare, including 78% of Democrats, 69% of independents, and 57% of Republicans.

President Trump first pushed to lower prescription drug costs in the U.S. to match prices in other developed nations, during his first term in 2018, an approach that later became formally known as “most-favored-nation” (MFN) pricing. While this was not put into effect during Trump’s first term, KFF polling from 2019 found broad public support for the approach, with about two-thirds (65%) of adults supporting lowering what Medicare pays for some drugs based on amounts in other countries where governments more closely control prices. This includes most Democrats (74%), independents (62%), and Republicans (54%).

In the Trump administration’s second term, there have been more efforts to reduce the cost of prescription drugs. Though the details of the deals are confidential and not available to the public, the administration announced several prescription drug pricing deals with drugmakers related to what they charge state Medicaid programs for some of their drugs, and a subsequent deal with a maker of in vitro fertilization (IVF) drugs aimed at lowering the cost of these treatments. As of November 2025, awareness of these deals was limited, with three in ten adults saying they had heard a lot (6%) or some (25%) about them. Later in 2025, the president announced further developments in the MFN pricing, including deals to sell certain products directly to consumers at discounted rates.

In February 2026, amid the Trump administration’s focus on lowering prescription drug costs, the administration officially launched TrumpRx, the federal government-run website where people can get discounts to buy prescription drugs directly from some manufacturers or pharmacies, without using their health insurance. As of early March 2026, few U.S. adults overall, including those who take prescription drugs, have heard much about or visited the website.

While few prescription drug users (7%) say they have visited the TrumpRx site to shop for or compare prescription prices in the month following the TrumpRx launch, this rises to about one in six (16%) among those who currently take or have ever taken a GLP-1 medication for weight loss or certain chronic conditions. The TrumpRx website features at least four major GLP-1 medications among its initial 43 listed drugs.

Prior to the launch of TrumpRx, drug discounts have been available through third-party platforms and directly from drug manufacturers. About four in ten adults who take prescription drugs say that in the past year, they have used a discount card or coupon to reduce their prescription drug costs (42%) or compared prescription drug prices online to find the lowest cost option (39%). Fewer say they have purchased a lower-cost drug from an online pharmacy without their insurance (15%) or directly from a drug manufacturer’s website (8%). 

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 and nearly all states completed 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 December 2025 include:

• There are 75.7 million people enrolled in Medicaid/CHIP nationally (Figure 1). This represents an 20% decline from total Medicaid/CHIP enrollment in March 2023, but is still 6% 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 seventeen states (AK, AR, AZ, CO, FL, ID, IA, LA, MI, MT, NH, NM, SC, TN, TX, VT and WV). Enrollment changes from pre-pandemic baseline vary from a 17% 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 35.3 million children (48%) and 38.7 million adults (52%) 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 23 states, while adult enrollment is below pre-pandemic levels in 15 states (Figure 2).
• There are 68.5 million people enrolled in Medicaid and 7.2 million people enrolled in CHIP (Figure 1). More states report CHIP enrollment above their pre-pandemic baselines compared to the number reporting Medicaid enrollment above the baseline (Figure 2).

Note: The data on unwinding renewal outcomes presented below were last updated on September 12, 2024; since most states have now completed the Medicaid unwinding, the information will not be updated again.

As of September 12, 2024 and with nearly complete unwinding data for most states: 

• Over 25 million people were disenrolled (31% of completed renewals) and over 56 million people had their coverage renewed (69% of completed renewals).  
• Disenrollment rates varied across states from 57% in Montana to 12% in North Carolina, driven by a variety of factors including differences in renewal policies and procedures as well as eligibility expansions in some states.  
• Among those who were disenrolled, nearly seven in ten (69%) were disenrolled for paperwork or procedural reasons while three in ten (31%) were determined ineligible.  
• Among those whose coverage was renewed during the unwinding, 61% were renewed on an ex parte, or automated, basis, meaning the individual did not have to take any action to maintain coverage. 

State Data on Renewal Outcomes

The data on unwinding-related renewal outcomes presented in this section rely primarily on monthly reports that states were required to submit to the Centers for Medicare & Medicaid Services (CMS) during the unwinding period. The data also reflect updates to the monthly reports that states submit three months after the original report submission to account for the resolution of pending cases and any other changes in renewal metrics. For 13 states, data were pulled from dashboards or reports published on state websites that provide more complete information, and for a few additional states, updated monthly reports were pulled from state websites because they were more timely than what is reported on the CMS website. 

To view archived data for specific states, click on the State Data – Archived tab.

 

  

Medicaid Disenrollments

• As of September 12, 2024, at least 25,198,000 Medicaid enrollees had been disenrolled during the unwinding of the continuous enrollment provision. Overall, 31% of people with a completed renewal were disenrolled in reporting states while 69%, or 56.4 million enrollees, had their coverage renewed.
• There is wide variation in disenrollment rates across reporting states, ranging from 57% in Montana to 12% in North Carolina. A variety of factors contribute to these differences, including differences in renewal policies and system capacity. Some states adopted policies that promote continued coverage among those who remain eligible and/or have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually-driven systems. In addition, North Carolina and South Dakota adopted Medicaid expansion and other states increased eligibility levels for certain populations (e.g., children, parents, etc.) during the unwinding, which may have lowered disenrollment rates in these states.

 

• Across all states with available data, 69% of all people disenrolled had their coverage terminated for procedural reasons. However, these rates vary based on how they are calculated (see note below). Procedural disenrollments are cases where people are disenrolled because they did not complete the renewal process and can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe. High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage. 

(Note: The first tab in the figure below calculates procedural disenrollment rates using total disenrollments as the denominator. The second tab shows these rates using total completed renewals, which include people whose coverage was terminated as well as those whose coverage was renewed, as the denominator. And finally, the third tab calculates the rates as a share of all renewals due, which include completed renewals and pending cases.)

Medicaid Renewals

• Of the people whose coverage has been renewed as of September 12, 2024, 61% were renewed on an ex parte basis while 39% were renewed through a renewal form, though rates vary across states. Under federal rules, states are required to first try to complete administrative (or “ex parte”) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee. Ex parte renewal rates varied across states from 90% or more in Arizona, North Carolina, and Rhode Island to less than 20% in Pennsylvania and Texas. 

Federal Data on Renewal Outcomes

The data presented here are cumulative unwinding metrics published by CMS. These counts and percentages may differ from the above data, which present renewal metrics reported on state websites when state-reported data are more complete.  

Figure 1 below shows cumulative renewal data reported by CMS during states’ unwinding periods. Renewal data for the months after the end of states’ unwinding period are excluded. The data reflect updated unwinding data reported by states three months after the original monthly reports as they become available.   

For questions about this tracker, please contact KFFTracker@kff.org

Note: The state data presented below were last updated on September 12, 2024; since most states have now completed the Medicaid unwinding, the information will not be updated again. 

The data presented here provide state-level data on enrollment trends and renewal outcomes during the unwinding period. Figure 1 shows total Medicaid enrollment by month starting in January 2023 and, once disenrollments resumed in a state, the cumulative percent change in Medicaid enrollment relative to the month before Medicaid disenrollments started (this baseline month will differ across states). Figure 2 shows renewal metrics for each month of a state’s unwinding period (or cumulative data for the unwinding period for some states). 

For total national Medicaid enrollment, click on the Enrollment Data tab.

Resources on unwinding data

• An Examination of Medicaid Renewal Outcomes and Enrollment Changes at the End of the Unwinding
• How Did Medicaid Renewal Outcomes Change During the Unwinding?
• KFF Survey of Medicaid Unwinding
• Three Questions About Medicaid Unwinding: What We Know and What to Expect
• Halfway Through the Medicaid Unwinding: What Do the Data Show?
• Unwinding of Medicaid Continuous Enrollment: Key Themes from the Field
• Navigating the Unwinding of Medicaid Continuous Enrollment: A Look at Enrollees Experiences
• Six Months into the Medicaid Unwinding: What Do the Data Show and What Questions Remain?
• What Do Medicaid Unwinding Data by Race and Ethnicity Show?
• Understanding Medicaid Ex Parte Renewals During the Unwinding
• States Obtain Special Waivers to Help Unwinding Efforts
• Understanding Medicaid Procedural Disenrollment Rates
• Do State Decisions to Prioritize Renewals for Medicaid Enrollees Who are Likely Ineligible Affect Early Disenrollment Rates?
• What Do the Early Medicaid Unwinding Data Tell Us?
• How Many People Might Lose Medicaid When States Unwind Continuous Enrollment?

Resources on state policies and preparations for the unwinding

• A Look at Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies During the Unwinding of Continuous Enrollment and Beyond
• State Policy Choices Are Likely to Affect the Extent of Medicaid Enrollment Declines During the Unwinding Period
• Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Prepare for the Unwinding of the Pandemic-Era Continuous Enrollment Provision
• The Unwinding of Medicaid Continuous Enrollment: Knowledge and Experiences of Enrollees
• Unwinding the Continuous Enrollment Provision: Perspectives from Current Medicaid Enrollees

Resources on pre-pandemic enrollment patterns and coverage transitions

• What Happens After People Lose Medicaid Coverage?
• Medicaid Enrollment Growth: Estimates by State and Eligibility Group Show Who may be at Risk as Continuous Enrollment Ends
• Unwinding the PHE: What We Can Learn From Pre-Pandemic Enrollment Patterns
• Medicaid Enrollment Churn and Implications for Continuous Coverage Policies
• Implications of Continuous Eligibility Policies for Children’s Medicaid Enrollment Churn
• Medicaid Enrollment Patterns During the Postpartum Year

KFF’s unwinding explainer

• 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision