WASHINGTON — Enrollment of children in Medicaid and the Children’s Health Insurance Program (CHIP) has fallen below pre-pandemic levels for the first time since the COVID-19 public health emergency, according to newly released federal and independent health policy data, raising concerns among child health advocates about potential increases in the number of uninsured children.
Data published this month by the nonpartisan health research organization KFF, based on federal enrollment figures, showed that as of February 2026 there were about 345,000 fewer children enrolled in Medicaid and CHIP than in February 2020, just before the pandemic began. The decline follows several years of enrollment growth during pandemic-era protections that allowed beneficiaries to remain continuously enrolled in coverage.
The enrollment drop comes after states completed the unwinding of those temporary protections, which ended regular eligibility reviews for Medicaid recipients during the public health emergency. Child enrollment in Medicaid and CHIP rose sharply between 2020 and 2023 but has declined steadily since states resumed eligibility redeterminations and renewals.
According to the Centers for Medicare and Medicaid Services (CMS), approximately 35.7 million children were enrolled in Medicaid or CHIP in February 2026, accounting for nearly half of all Medicaid and CHIP beneficiaries nationwide. CMS said the figures reflect enrollment reported by states and the District of Columbia.
“Child enrollment in Medicaid/CHIP dropped below pre-pandemic levels for the first time,” KFF said in an analysis released on June 1. The organization noted that enrollment among children fell by about 1% compared with February 2020 levels.
Health policy researchers said the decline has occurred even as overall Medicaid and CHIP enrollment remains above pre-pandemic levels nationally. KFF reported that total program enrollment remained higher than it was before the pandemic, although child enrollment has now moved below that benchmark.
Advocacy groups and researchers have expressed concern that some children who lost coverage may not transition to other forms of health insurance. The Georgetown University Center for Children and Families said enrollment losses among children have accelerated in recent months and warned that historical trends suggest declines in Medicaid and CHIP participation can lead to increases in uninsured rates among children.
Supporters of tighter eligibility verification procedures have argued that periodic reviews help ensure public benefits are directed to eligible recipients and improve program integrity. Federal officials have not indicated that eligibility standards for children have been broadly reduced.
As of June, federal health officials continued to monitor enrollment trends through monthly reporting systems. Additional data later this year may provide a clearer picture of how many children who left Medicaid or CHIP obtained alternative coverage and how enrollment changes have affected national uninsured rates.
