Note: This tracker was first published on May 3 and is updated regularly as new data become available.
The Medicaid Enrollment and Unwinding Tracker presents the most recent data on monthly Medicaid disenrollments, renewals, overall enrollment and other key indicators reported by states during the unwinding of the Medicaid continuous enrollment provision. The unwinding data are pulled from state websites, where available, and from the Centers for Medicare & Medicaid Services (CMS).
To view data for specific states, click on the State Data tab.
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Medicaid Disenrollments
Medicaid Renewals
Net Change in Medicaid Enrollment
Background
Medicaid Disenrollments
- At least 24,156,000 Medicaid enrollees have been disenrolled as of July 12, 2024, based on the most current data from all 50 states and the District of Columbia. Overall, 30% of people with a completed renewal were disenrolled in reporting states while 70%, or 53.7 million enrollees, had their coverage renewed (one reporting state does not include data on renewed enrollees). Due to varying lags for when states report data, the data reported here undercount the actual number of disenrollments to date.
- There is wide variation in disenrollment rates across reporting states, ranging from 57% in Utah to 12% in North Carolina. Differences in who states are targeting with early renewals as well as differences in renewal policies and system capacity likely explain some of the variation in disenrollment rates. Some states (such as Texas and South Carolina) initially targeted people early in the unwinding period that they think are no longer eligible or who did not respond to renewal requests during the pandemic, but other states are conducting renewals based on an individual’s renewal date. Additionally, some states have adopted several policies that promote continued coverage among those who remain eligible and have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually-driven systems.
- Across all states with available data, 69% of all people disenrolled had their coverage terminated for procedural reasons. However, these rates vary based on how they are calculated (see note below). Procedural disenrollments are cases where people are disenrolled because they did not complete the renewal process and can occur when the state has outdated contact information or because the enrollee does not understand or otherwise does not complete renewal packets within a specific timeframe. High procedural disenrollment rates are concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage. Some states have temporarily paused procedural terminations for some enrollees while they address problems in the renewal process that lead to increased procedural disenrollments.
(Note: The first tab in the figure below calculates procedural disenrollment rates using total disenrollments as the denominator. The second tab shows these rates using total completed renewals, which include people whose coverage was terminated as well as those whose coverage was renewed, as the denominator. And finally, the third tab calculates the rates as a share of all renewals due, which include completed renewals and pending cases.)
Medicaid Renewals
- Of the people whose coverage has been renewed as of July 12, 2024, 61% were renewed on an ex parte basis while 39% were renewed through a renewal form, though rates vary across states. Under federal rules, states are required to first try to complete administrative (or “ex parte”) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee.
Net Change in Medicaid Enrollment
- Net Medicaid enrollment declines range from 35.2% in Utah to 0.0% in North Carolina since the start of the unwinding period in each state. The net changes in Medicaid/CHIP enrollment reflect people who disenroll from Medicaid as states redetermine eligibility during the unwinding, new people who come onto the program, and people who reenroll within a short timeframe following disenrollment, referred to as “churn.” The enrollment decline is measured against each state’s baseline enrollment, which is enrollment in the month prior to when the state resumed disenrollments and which varies by state. In addition, the latest month of enrollment data also varies by state (see State Data Tab for each state’s baseline enrollment month and the latest enrollment).
Background on the Unwinding of the Medicaid Continuous Enrollment Provision
The Medicaid continuous enrollment provision, which had halted Medicaid disenrollments since March 2020, ended on March 31, 2023. Primarily due to the continuous enrollment provision, more than 94 million people were enrolled in Medicaid/CHIP in March 2023, the month before the unwinding period began, an increase of over 22 million from February 2020.
States began disenrolling people from Medicaid in different months, with some states resuming disenrollments in April, others in May or June, and even July 2023 or later for some states. Likewise, states will complete their unwinding periods at different points. The figure below shows the month in which the last cohort of unwinding renewals are scheduled to be completed in each state.
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