Medicaid/CHIP Monthly Enrollment Tracker | KFF

Note: The data presented below are updated monthly as new Medicaid/CHIP enrollment data become available.

This tracker presents the most recent data on monthly Medicaid and Children’s Health Insurance Program (CHIP) enrollment reported by the Centers for Medicare & Medicaid Services (CMS) as part of the Performance Indicator Project. It includes data for Medicaid and CHIP and reports enrollment data for children and adults. The data are generally the most recent data available and are useful for reporting trends in Medicaid enrollment. However, the data only capture full-benefit enrollees, excluding those who receive limited benefits, such as those who receive family planning services only, and consequently, do not provide a full count of the total population enrolled in Medicaid. Additionally, these data cannot be used to monitor changes in enrollment by eligibility pathway, including for adults in the Medicaid expansion group. Enrollment data for the full Medicaid population is available here, and for more information on how implementation of Medicaid work requirements is affecting Medicaid expansion enrollment, please see Tracking Implementation of the 2025 Reconciliation Law Medicaid Work Requirements.

Medicaid/CHIP Enrollment Trends

Following implementation of the Affordable Care Act’s (ACA) Medicaid expansion in January 2014, Medicaid enrollment increased as adults with income up to 138% of the federal poverty level (FPL) gained coverage. As more states adopted the expansion, Medicaid enrollment peaked at just over 75 million in March 2017 before declining steadily until the start of the COVID-19 pandemic in March 2020. By February 2020, enrollment had dropped to 71 million.

At the start of the pandemic, Congress enacted legislation that included a provision that Medicaid programs keep people continuously enrolled in exchange for enhanced federal funding. As a result, national Medicaid/CHIP enrollment increased to a record high of 94 million enrollees in March 2023 when the continuous enrollment provision ended. The unwinding of this provision started on April 1, 2023, and millions were disenrolled from Medicaid over the subsequent 16 months. By September 2024, national Medicaid/CHIP enrollment had dropped to 80 million. Medicaid enrollment stabilized briefly at the end of 2024 but began declining again in March 2025.

Passage of the 2025 reconciliation bill in July 2025 included significant changes to Medicaid that are expected to reduce Medicaid enrollment over the next 10 years relative to what would have been expected under current law. For the first time, the law conditions Medicaid eligibility for Medicaid expansion enrollees on meeting work and reporting requirements. These work requirements, which will go into effect in January 2027, or sooner at state option, represent the largest source of enrollment declines in the law. The bill also restricts eligibility for certain immigrant populations starting in October 2026, which is also expected to affect Medicaid enrollment.

The figures below show Medicaid and CHIP enrollment from February 2020 through the most current month of available data. Figures include enrollment for adults and children in Medicaid/CHIP and for Medicaid only and CHIP only. Key enrollment data and trends as of April 2026 include:

• There were 73.9 million people enrolled in Medicaid/CHIP nationally (Figure 1). Medicaid enrollment declined by 5 million or 6% from April 2025 through April 2026 (Table 1).
• Total Medicaid/CHIP enrollment has decreased in all states since April 2025. Enrollment changes since April 2025 vary from a less than 1% decrease in Iowa to a 20% decrease in Indiana (Figure 2).
• Child enrollment in Medicaid/CHIP decreased in all states and DC but Hawaii from April 2025 through April 2026. Adult enrollment has decreased in all but five states (IA, MO, NC, OK, SD) (Figure 2).
• There were 66.7 million people enrolled in Medicaid and 7.1 million people enrolled in CHIP (Figure 1). Since April 2025, Medicaid enrollment has decreased in all states and DC but Iowa while CHIP enrollment has increased in eighteen states (AL, CA, CT, DE, FL, HI, IL, MO, NJ, NM, NC, ND, RI, SC, TN, VT, WA, WI).
• Total Medicaid/CHIP enrollment was 3% higher in April 2026 compared to enrollment in February 2020, prior to the pandemic. However, in the 49 states and DC with complete enrollment data by age, the number of children enrolled in Medicaid/CHIP declined by 631,000 or 2% from February 2020 to April 2026 (Figure 2 and Table 1).