Medicaid is the largest single source of health coverage in the United States. Together with the Children’s Health Insurance Program (CHIP), it covered 108 million people – nearly one in three Americans—at some point during fiscal year 2024, including 99 million people enrolled in Medicaid. Medicaid and CHIP cover nearly 40% of all children and more than 40% of nonelderly adults with disabilities. Medicaid also covers millions of seniors, including more than 60% of nursing home residents.
This coverage is now under threat as a result of recent changes in Medicaid. Between January 2025 and April 2026, combined Medicaid and CHIP enrollment fell in every congressional district. The average district lost roughly 12,700 enrollees – a 7% decline – from 182,100 people to 169,400. Enrollment fell by 5% or more in 263 districts and by 10% or more in 95 districts.
Three-quarters of the decline came after July 2025, when Congress passed the 2025 budget reconciliation law, which cuts federal Medicaid sending by $915 billion over the next decade, and coverage losses are expected to increase significantly because the law’s largest funding cuts have yet to take effect. Beginning next year, most adults covered through the Affordable Care Act’s Medicaid expansion must prove their eligibility every six months instead of once a year, and many will have to document at least 80 hours of work, school, or community service each month to keep their coverage. The Congressional Budget Office estimates that these provisions will increase the number of uninsured by 6 million and the law’s total Medicaid cuts will leave 7.5 million people uninsured.
Note: estimates were published on August 11, 2026.
