Why nearly a million Americans lost their healthcare coverage in just one month
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Health care coverage is something many depend on for peace of mind—but in just a short span of time, hundreds of thousands found themselves unexpectedly dropped from Medicaid or CHIP.
The change has left many asking: what happened, and what can be done to prevent others from losing coverage too?
According to recent data from the nonprofit KFF, more than 750,000 Americans were removed from Medicaid or the Children’s Health Insurance Program (CHIP) between October and November 2024.
The sudden drop has prompted new discussions about state policies, pandemic protections, and what individuals can do to stay covered.
During the height of the COVID-19 pandemic, special rules were put in place to make sure people didn’t lose their health coverage.
The Families First Coronavirus Response Act included a "continuous enrollment" policy that temporarily blocked states from removing people from Medicaid or CHIP.
This helped millions maintain insurance during uncertain times.
That policy ended in March 2023.
Since then, states have resumed a process called “redetermination,” where eligibility is reviewed.
As that process picked up again, some enrollees—often unaware of the changes or unsure of how to respond—lost coverage.
In fact, enrollment surged by over 13 million during the pandemic but has been declining since those protections were lifted.
In October 2024, there were about 79.8 million people enrolled in Medicaid or CHIP.
By November, that number had dropped to 79 million.
While this figure is still higher than pre-pandemic enrollment in February 2020 (around 71.4 million), it’s a notable drop from the peak of 94.6 million in April 2023.
Not all states have seen the same trend.
Nine states—including Arkansas, Colorado, Idaho, Iowa, Montana, South Carolina, Tennessee, Texas and West Virginia—now have fewer enrollees than before the pandemic.
Others, like North Carolina, have seen major increases. North Carolina leads the country with a 50% jump in enrollments.
On the opposite end, Montana reported a 14% decrease.
How states handle their Medicaid and CHIP programs can significantly impact enrollment.
For example, Pennsylvania saw a drop after identifying a large group of people as "likely ineligible" once federal protections ended.
Health care advocates say the situation reflects uneven coverage protections across the country.
Ben Anderson of Families USA noted that while states like Oregon and California have expanded coverage, others—including Texas, Florida, and Georgia—have experienced disruptions that might have been avoidable.
The Trump administration has publicly denied any plans to cut Medicaid or Medicare.
Still, ongoing concerns about fraud—estimated at $521 billion annually, mostly tied to these programs—have led some to believe stricter oversight may be on the horizon.
For many older adults, Medicaid or CHIP helps cover costs that would otherwise be out of reach.
Losing that coverage—especially without warning—can lead to missed treatments, medical debt, or delayed care.
That’s why it’s so important to stay informed and check on enrollment status regularly.
Read next: Risk alert: Is your state about to slash your Medicaid coverage?
Have you or someone you know been affected by recent changes to Medicaid or CHIP coverage? What do you think about how different states are handling this shift? Share your story in the comments—we welcome thoughtful discussion as we all try to navigate these changes together.
The change has left many asking: what happened, and what can be done to prevent others from losing coverage too?
According to recent data from the nonprofit KFF, more than 750,000 Americans were removed from Medicaid or the Children’s Health Insurance Program (CHIP) between October and November 2024.
The sudden drop has prompted new discussions about state policies, pandemic protections, and what individuals can do to stay covered.
Recent shifts in health care programs are prompting new questions about coverage and eligibility across the country. Image Source: Pexels / Leeloo The First.
What caused the decline?
During the height of the COVID-19 pandemic, special rules were put in place to make sure people didn’t lose their health coverage.
The Families First Coronavirus Response Act included a "continuous enrollment" policy that temporarily blocked states from removing people from Medicaid or CHIP.
This helped millions maintain insurance during uncertain times.
That policy ended in March 2023.
Since then, states have resumed a process called “redetermination,” where eligibility is reviewed.
As that process picked up again, some enrollees—often unaware of the changes or unsure of how to respond—lost coverage.
In fact, enrollment surged by over 13 million during the pandemic but has been declining since those protections were lifted.
Also read: Millions may lose Medicaid—see which states are most affected
The numbers behind the shift
In October 2024, there were about 79.8 million people enrolled in Medicaid or CHIP.
By November, that number had dropped to 79 million.
While this figure is still higher than pre-pandemic enrollment in February 2020 (around 71.4 million), it’s a notable drop from the peak of 94.6 million in April 2023.
Not all states have seen the same trend.
Nine states—including Arkansas, Colorado, Idaho, Iowa, Montana, South Carolina, Tennessee, Texas and West Virginia—now have fewer enrollees than before the pandemic.
Others, like North Carolina, have seen major increases. North Carolina leads the country with a 50% jump in enrollments.
On the opposite end, Montana reported a 14% decrease.
Also read: Is your health coverage safe? Why Medicaid could face major cuts
State policies play a big role
How states handle their Medicaid and CHIP programs can significantly impact enrollment.
For example, Pennsylvania saw a drop after identifying a large group of people as "likely ineligible" once federal protections ended.
Health care advocates say the situation reflects uneven coverage protections across the country.
Ben Anderson of Families USA noted that while states like Oregon and California have expanded coverage, others—including Texas, Florida, and Georgia—have experienced disruptions that might have been avoidable.
Also read: Phantom payments: Medicaid payments raise questions after millions spent on ineligible recipients
What’s being said at the federal level
The Trump administration has publicly denied any plans to cut Medicaid or Medicare.
Still, ongoing concerns about fraud—estimated at $521 billion annually, mostly tied to these programs—have led some to believe stricter oversight may be on the horizon.
What you can do
- Stay informed: Keep up with news related to Medicaid and CHIP.
- Check your enrollment: Make sure your information is current so you don’t lose coverage by accident.
- Speak up: If you’re concerned, contact your state lawmakers and share your views on keeping health care accessible.
For many older adults, Medicaid or CHIP helps cover costs that would otherwise be out of reach.
Losing that coverage—especially without warning—can lead to missed treatments, medical debt, or delayed care.
That’s why it’s so important to stay informed and check on enrollment status regularly.
Read next: Risk alert: Is your state about to slash your Medicaid coverage?
Have you or someone you know been affected by recent changes to Medicaid or CHIP coverage? What do you think about how different states are handling this shift? Share your story in the comments—we welcome thoughtful discussion as we all try to navigate these changes together.
