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Nearly 6 million children gained Medicaid/CHIP coverage during pandemic

March 1, 2023

An estimated 41.1 million U.S. children (55%) were enrolled in Medicaid or the Children's Health Insurance Program (CHIP) as of August 2022 — an increase of 5.8 million children since March 2020, according to an AAP analysis of data from the Centers for Medicare & Medicaid Services (CMS) (see figure).

When the Families First Coronavirus Response Act was signed into law in March 2020, states received an increase in federal Medicaid matching payments if they continued to cover all Medicaid/CHIP enrollees for the duration of the public health emergency. As of April 1, states can start disenrolling families from coverage if they do not meet eligibility requirements. States will be required to conduct eligibility redeterminations for all enrollees over a 14-month period — a process referred to as “unwinding.”

A report from the Georgetown Center for Children and Families estimates that up to 6.7 million children could lose coverage during the unwinding (

“The public health emergency was instrumental in keeping millions of children insured during the pandemic; now we must ensure that those who remain eligible maintain their coverage and timely access to care,” said AAP CEO/Executive Vice President Mark Del Monte, J.D. “As the source of insurance for more than half of U.S. children, these public programs are core to the financing and structure of U.S. pediatric health care.”

All states reported increases in children’s enrollment in Medicaid/CHIP during the pandemic, with the largest increases in Texas (871,578 children), Florida (565,817), California (414,967) and Georgia (397,775), according to the AAP analysis. In 31 states, more than half of children are enrolled in Medicaid/CHIP.

The AAP has developed tools to help chapters prepare for the end of the continuous enrollment requirements and recently held a webinar with chapters outlining what pediatricians need to know and strategies for local advocacy.

Pediatricians also can help by making sure families update their contact information with the state Medicaid agency through their patient portal or customer service line, especially if they have moved over the last few years.

Data used for the AAP analysis are based on the CMS Medicaid and CHIP performance indicator project.


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