A shocking new study reveals the largest healthcare coverage loss in American history. More than 25 million Americans lost their Medicaid health insurance in the last two years. That’s nearly 8% of everyone living in the United States. A major new study published on October 10, 2025, calls this one of the biggest drops in Medicaid history.
The study appeared in JAMA Health Forum, a respected medical journal. Dr. Adrianna McIntyre from Harvard led the research team that looked at what happened when states started checking who should still get Medicaid.
During the COVID-19 pandemic, the government made a special rule. Nobody could lose their Medicaid coverage, even if their income changed. This kept people insured during hard times. But that rule ended in 2023, and states had to check everyone’s eligibility again for the first time in three years.
The results were dramatic. Different states removed very different numbers of people. Some states took away coverage from fewer than 15% of people. Other states kicked out more than 35%. That’s a huge difference of over 20 percentage points.
By September 2024, about 31% of people who got checked lost their Medicaid or CHIP coverage. CHIP stands for Children’s Health Insurance Program, which helps kids whose families earn too much for Medicaid but can’t afford private insurance.
Children suffered the most. Over 5.5 million kids lost their health insurance—that’s one out of every three people who got removed. Between March 2023 and December 2024, child enrollment dropped by 11%. Adult enrollment fell even more, dropping 19%.
Certain groups of children faced higher risks of losing coverage:
- Babies younger than 1 year old
- Teenagers aged 12 to 17
- Girls more than boys
- American Indian and Alaska Native children
- Kids with serious health problems
Here’s the frustrating part: Most people lost coverage for paperwork reasons, not because they didn’t qualify anymore. Over two-thirds of removals were called “procedural terminations.” This means states couldn’t figure out if people still qualified because:
The person never got the renewal forms in the mail. They couldn’t fill out the complicated paperwork. The state had old addresses or phone numbers after three years. Many people who lost Medicaid might have still qualified. They just couldn’t get through the bureaucratic maze. Experts call this “administrative churn”—losing coverage because of red tape, not because you don’t need help.
Early guesses suggested nearly half of the people removed could have kept their insurance if the system worked better.
Here’s something surprising: Even though 25 million people lost Medicaid, the number of uninsured Americans barely changed. This confused many people, so researchers dug deeper.
They found several reasons why. Many people quickly signed back up for Medicaid after fixing their paperwork problems. Others found different insurance, like coverage from their job or plans from Healthcare.gov. Some people got confused and told surveys they didn’t have insurance when they actually did.
The study compared what people said in surveys with actual government records. The numbers didn’t match up. Survey data counted way fewer people with Medicaid than official records showed, especially for children. The difference was almost 20 percentage points for kids.
Medicaid applications tell an interesting story. During the pandemic when nobody could be removed, monthly applications dropped by about 30%. People knew they’d keep their coverage no matter what.
But when states started checking eligibility again, applications jumped way up. This happened most in states that removed the most people. It shows that people who lost coverage immediately tried to get back on the program.
While the overall uninsured rate stayed stable, things changed underneath the surface. Some groups of people reported more trouble paying for medical care. More women got private insurance, showing how coverage types shifted around.
The study found worrying patterns. People who earn too much for Medicaid but could get help buying Healthcare.gov plans often fail to make that switch. They end up with dangerous gaps in coverage.
Research proves that gaps in health insurance hurt people. Even switching insurance without a gap can cause problems. People might face surprise medical bills or lose access to their regular doctors.
When people lose coverage, bad things happen. They delay doctor visits they need. They skip getting preventive care like checkups. They don’t refill their prescription medicines. They use emergency rooms more often, which costs everyone more money.
States made mistakes that especially hurt children. Many states checked whole families together instead of checking each person separately. This was wrong because kids can qualify for Medicaid or CHIP even when parents earn too much money. Children’s programs have more generous income rules.
Some states forgot to check if kids qualified for CHIP when they lost Medicaid. A child might lose one program but immediately qualify for the other based on family income.
The researchers looked at enrollment numbers from 2019 to 2024 across all 50 states and Washington, D.C. During this time, Medicaid enrollment ranged from 72 million to 94.4 million people. They used computer models to see how changes affected different groups based on race, income, and health conditions.
Doctors and health clinics that serve poor families are struggling. Community health centers that care for one in nine children already operate with very little money. When patients lose Medicaid, these centers lose money too. This makes it harder for them to help anyone.
Some health centers help patients keep their coverage, which probably means the real number of kids who lost insurance is even higher than 8.7%. Some families might have stopped going to the doctor completely when they lost coverage.
Experts recommend better ways to prevent eligible people from losing coverage. Ideas include improving how states communicate with families, watching patterns of who loses coverage, letting children stay enrolled longer, and checking eligibility less often.
The unwinding period created new rules requiring states to report detailed information about who lost coverage and why. Researchers say this transparency matters. The public data helped protect vulnerable families.
However, some members of Congress want to check Medicaid eligibility more often to save government money. Experts warn that hiding this data from the public would hurt the millions of families who depend on Medicaid.
The study authors say states can learn from each other. Some states did much better jobs keeping eligible people enrolled. Sharing those successful strategies could help millions of Americans keep the health coverage they need and deserve.
