Charlotte, NC, December 11, 2025
Recent reports indicate a sharp decline in Medicaid and Medicare enrollments, reaching a 14-year low. The decrease is linked to the end of continuous enrollment that was established during the COVID-19 pandemic. This trend raises serious concerns about healthcare access, particularly for vulnerable populations including children, with millions losing coverage. Stakeholders are urged to monitor these trends closely to ensure coverage stability.
Significant Decline in Medicaid and Medicare Enrollment Raises Concerns
The recent reports unveil a sharp drop in healthcare program enrollments, prompting discussions on coverage stability and child health.
Charlotte, NC – The Centers for Medicare & Medicaid Services (CMS) has indicated a notable decline in enrollment within its Medicaid and Medicare programs, reaching a 14-year low. This downturn is largely linked to the unwinding of the continuous enrollment provision put in place during the COVID-19 pandemic, raising questions about its impact on vulnerable populations.
Declining Enrollment in Medicaid and CHIP
As of January 2025, Medicaid and the Children’s Health Insurance Program (CHIP) reported a drop in enrollment, with the total number falling to 71.4 million individuals. This represents a staggering decrease of 9.3% since March 2023, the last month under the continuous enrollment provision established by the Families First Coronavirus Response Act (FFCRA). This reduction in enrollment signifies a critical shift in healthcare access following pandemic-era policies.
Focus on Children’s Health Coverage
The decline in enrollment has had a particular impact on children, with approximately 2.3 million children losing their coverage between March 2023 and September 2023. This represents a 5.5% decrease in enrollment for children under Medicaid and CHIP. The implications of this drop are serious; experts worry about a potential rise in uninsured rates among children, posing challenges for their access to essential healthcare services.
Projected Impact on Medicare Advantage Enrollment
Meanwhile, the Medicare sector is also seeing shifting dynamics, as enrollment in Medicare Advantage plans is predicted to decline for the first time in nearly two decades. Projections suggest a drop from 34.9 million enrollees in 2025 to 34 million in 2026, marking a 2.6% decrease. This drop in enrollment is expected to shrink the percentage of Medicare beneficiaries enrolled in Advantage plans from 50% down to 48%.
The Background of Continuous Enrollment
The continuous enrollment provision, which began in March 2020, was a lifeline for many during the pandemic, enabling individuals to retain their Medicaid coverage without regular eligibility checks. As this provision ended in December 2023, states have begun reevaluating eligibility, contributing to the current decline in enrollment for these critical healthcare programs.
The evolving healthcare landscape underscores continuous challenges as the system adjusts to post-pandemic realities. Stakeholders across sectors will need to monitor these trends closely to ensure that gaps in coverage are addressed and that healthcare access remains stable for those who depend on it.
FAQ
What is the continuous enrollment provision?
The continuous enrollment provision was a policy implemented during the COVID-19 pandemic that allowed individuals to maintain their Medicaid coverage without periodic eligibility checks, providing stability during the pandemic.
How has the end of the continuous enrollment provision affected Medicaid enrollment?
Since the end of the continuous enrollment provision in December 2023, states have begun reassessing eligibility, leading to a significant decline in Medicaid and CHIP enrollment, with a 9.3% decrease since March 2023.
What impact has the enrollment decline had on children’s coverage?
Children have been particularly affected, with a 5.5% decrease in Medicaid/CHIP enrollment from March 2023 to September 2023, raising concerns about potential increases in uninsured rates among children.
What are the projections for Medicare Advantage enrollment?
Medicare Advantage enrollment is projected to decline for the first time in nearly two decades, with projections indicating a decrease from 34.9 million enrollees in 2025 to 34 million in 2026, reducing the proportion of Medicare beneficiaries in Advantage plans from 50% to 48%.
Key Features
| Feature | Details |
|---|---|
| Continuous Enrollment Provision | Policy allowing individuals to maintain Medicaid coverage without periodic eligibility checks during the COVID-19 pandemic. |
| Medicaid and CHIP Enrollment Decline | 9.3% decrease in enrollment since March 2023, with 71.4 million individuals enrolled as of January 2025. |
| Impact on Children’s Coverage | 5.5% decrease in Medicaid/CHIP enrollment from March 2023 to September 2023, raising concerns about uninsured rates among children. |
| Medicare Advantage Enrollment Projections | Projected decline from 34.9 million enrollees in 2025 to 34 million in 2026, reducing the proportion of Medicare beneficiaries in Advantage plans from 50% to 48%. |
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