Child uninsured rate likely on the rise
Our state-by-state Medicaid/CHIP enrollment tracker now indicates that 2 million fewer children were enrolled in Medicaid and CHIP as of April, 2026 as compared to January 2025 when President Trump took office.
That steep drop in the number of children enrolled in Medicaid or CHIP since January 2025 should sound the alarm for federal officials. The federal government’s own enrollment data shows a 4% decline in the number of children enrolled in Medicaid/CHIP during the President’s first year in office which equates to 1.5 million children. Our tracker uses more up-to-date data we collect directly from state websites (where available) and shows that 2 million fewer children are enrolled.
This is terrible news because when child enrollment in Medicaid and CHIP goes down, the child uninsured rate goes up. And the child uninsured rate was already going up when President Trump took office yet we have heard nothing about this from them. Federal officials should be scrambling to figure out the root cause of this coverage loss for children as the family income eligibility levels did not change and the unemployment rate has been inching upwards since President Trump took office.
I’ve shared some of our thoughts previously on what may be causing this sharp drop in child Medicaid enrollment. At a time when families are facing cost pressures on many fronts, a child being uninsured for even one month exposes the family to potential financial ruin if a trip to the emergency room is needed due to a broken bone or an untreated asthma attack.
How does this compare to Trump’s first term? Medicaid enrollment also declined during President Trump’s first term in office, and the child uninsured rate rose as a consequence. We know this because employer-sponsored insurance for children stayed level or rose and public coverage declined while the child uninsured rate went up a percentage point from a historic low of 4.7% in 2016 to 5.7% in 2019. Of course, in 2020 the COVID-29 pandemic hit and Medicaid coverage was guaranteed throughout the public health emergency so the number of uninsured kids started going down again once that period ended.
Medicaid/CHIP enrollment from December 2017 to December 2018 declined by a cumulative 828,000 children[1] – a decline of 2.2% after a very small decline during President Trump’s first year in office of 0.1%.
So, the rate of child Medicaid enrollment decline is happening more rapidly during President Trump’s second term which is ominous — since Medicaid cuts from H.R. 1 have largely not even kicked in yet. A recent slide set from the Congressional Budget Office (CBO) estimates that the number of children covered by Medicaid will decline by 3 million from 2026 to 2036 – although it is not clear how CHIP enrollment might change during this period from the slides.
At a recent press conference on alleged Medicaid fraud, Vice-President Vance claimed that efforts to reduce fraud were in service of protecting low-income kids who need health care. A more productive effort for this Administration would be to start exploring why so many children are losing Medicaid and what they can do about it ASAP and reverse a disaster in the making.
[1] Note that this total does not include data from AZ, DC, and TN.