Despite redeterminations, Medicaid enrollment is higher than pre-pandemic levels

By Paige Minemeyer / September 20, 2024

The Medicaid unwinding is coming to a close, and a new analysis from KFF finds that while many people have lost coverage during this period, enrollment remains above pre-pandemic levels.

The report estimates that more than 25 million people were disenrolled as part of the Medicaid redeterminations, while more than 56 million renewed coverage successfully. However, while millions have lost coverage, there are about 10 million more people enrolled in Medicaid and the Children's Health Insurance Program (CHIP) compared to the start of the COVID-19 pandemic.

KFF found that most states completed the redeterminations with higher enrollment than they reported in February 2020. In seven states, enrollment was 30% above pre-pandemic levels.

Also playing a role is the fact that five states—Missouri, Nebraska, North Carolina, Oklahoma, and South Dakota—expanded their Medicaid programs since the pandemic began, KFF said.

"There have always been people eligible for Medicaid but not enrolled, as well as people who get dropped from Medicaid for failing to complete regular renewal processes," the researchers wrote. "During the unwinding period, many states took steps to improve their renewal systems, leading to fewer people getting dropped even though they remain eligible."

While overall enrollment trends are up, enrollment among children is back to closer to pre-pandemic levels, the study found. In 12 states, enrollment among children was below pre-COVID figures.

This suggests that there are children who are eligible for Medicaid or CHIP who were disenrolled during the redeterminations, the researchers said.

Across the country, 31% of people whose Medicaid coverage was evaluated as part of the unwinding were disenrolled, the researchers said. There were five states that had disenrollment rates over 50% and five with rates below 20%.