What Is the Medicaid Unwinding?
During the COVID-19 pandemic, Congress enacted continuous enrollment protections that prevented states from removing people from Medicaid. This safeguard kept millions of families covered during an unprecedented public health crisis. When those protections expired in March 2023, states began the massive process of re-evaluating eligibility for every person enrolled in Medicaid — more than 90 million people nationwide.
The unwinding process was always going to be disruptive, but the scale of coverage losses has exceeded even the most pessimistic projections. Millions of people have been disenrolled not because they are ineligible, but because of paperwork problems, outdated addresses, and bureaucratic backlogs. States have struggled to process the enormous volume of renewals, and many eligible families have fallen through the cracks.
By mid-2026, more than 25 million people have been disenrolled from Medicaid since the unwinding began. Independent analyses estimate that a significant share of those removed were still eligible for coverage but lost it due to procedural reasons rather than a genuine change in their circumstances.
Children Are the Hardest Hit
Children make up a disproportionate share of those losing Medicaid coverage during the unwinding. Nearly half of all Medicaid disenrollments have been children, even though kids are more likely to remain eligible than adults. This is because children do not fill out their own paperwork — they depend entirely on parents and guardians to navigate a renewal process that many families find confusing and inaccessible.
Before the unwinding, the nation's uninsured rate for children had reached historic lows, with Medicaid and CHIP covering more than 40 million kids. Now those gains are being reversed at an alarming pace. Pediatricians report seeing families show up for well-child visits only to discover their coverage has lapsed. Vaccinations, developmental screenings, and chronic disease management are all being disrupted.
The consequences extend far beyond individual doctor visits. Research consistently shows that children who lose health coverage are less likely to receive preventive care, more likely to end up in emergency rooms, and more likely to experience long-term health problems that follow them into adulthood.
What Families Can Do Right Now
If your family has received a Medicaid renewal notice, respond immediately — even if you believe your information is up to date. Contact your state Medicaid office to confirm your mailing address, phone number, and email are current. Many states now offer online renewal portals that can simplify the process significantly.
If your child has already been disenrolled, you may be able to request reinstatement or reapply. Most states have processes for restoring coverage when someone was removed due to a procedural error. Community health centers, legal aid organizations, and enrollment assisters can help families navigate the system at no cost.
Families should also explore whether their children qualify for CHIP, which covers children in families with incomes too high for Medicaid but too low to afford private insurance. In many states, CHIP enrollment remains open year-round and provides comprehensive pediatric coverage.
The 2026 Threat Makes It Worse
Even as millions of children are still recovering from the unwinding, proposed federal budget cuts threaten to make the crisis dramatically worse. Congressional proposals to cut more than $1 trillion from Medicaid would force states to slash enrollment, reduce benefits, or both. Independent analysts project that 7.5 million could lose Medicaid coverage under these plans, with children once again facing disproportionate harm.
The proposed cuts would come on top of the unwinding losses, creating a compounding coverage crisis. States that expanded Medicaid under the Affordable Care Act could be forced to roll back expansion, and per-capita cap proposals would shift costs to states that are already straining under tight budgets. The result would be fewer children with access to regular checkups, dental care, mental health services, and the preventive care that keeps them healthy.
Protecting Medicaid is not a partisan issue — it is a children's issue. Every child deserves access to a doctor, and the programs that make that possible are under the most serious threat they have faced in decades. Families, advocates, and communities must speak up now to ensure that no child loses the coverage they need.