More than 1 million children in Texas have been rolled off the state’s Medicaid and Children’s Health Insurance Program (CHIP) over the course of just over two years, according to data from KFF, a nonprofit health policy research and news organization.
Child enrollment in Medicaid/CHIP in the state decreased by 27 percent, equating to just over one in four children, between March 2023 and June 2025, as part of the unwinding process happening nationwide after Medicaid coverage was expanded following the COVID-19 pandemic.
Newsweek has contacted the Texas Health and Human Services Commission via email for comment.
Why It Matters
The unwinding process has resulted in significant drops in Medicaid enrollment across the U.S., and with millions more Americans expected to lose coverage following the passage of President Donald Trump’s ‘One Big Beautiful Bill,’ according to Congressional Budget Office (CBO) forecasts.
After a new study highlighted that the majority of American children rely on Medicaid and CHIP in the first 18 years of their life, more concern has been raised about what higher uninsured rates among children means for their health outcomes long-term.
What To Know
In Texas, there were 4,372,154 children covered by Medicaid/CHIP in March 2023, but by June 2025, that number was 3,187,145, according to KFF data.
This drop is down to the unwinding process happening after the COVID-19 pandemic, as some states expanded Medicaid coverage under the Affordable Care Act (ACA), causing nationwide enrollment levels to increase.
Federal rules forced states to keep most Medicaid enrollees on the program, even if their eligibility status changed, until March 2023, when they were then allowed to start rolling recipients off the program.
As a result of this process, it means that more than 1 million children were disenrolled from Medicaid/CHIP, although it is not clear if they were able to access other forms of health insurance.
Some may have had access to employer-sponsored coverage, thanks to their parents’ jobs, or other forms of health coverage, but others may not have had the same opportunity and may “remain uninsured for long periods of time,” Brendan Saloner, a professor of health services, policy, and practice at the Brown University School of Public Health, told Newsweek.
“These effects will be felt differently,” he said, with impacts being “worse among children with complex health needs and from minority backgrounds.”
While Texas has seen a considerable decline in enrollment, other states have differing rates of disenrollment.
This is because some states were “more proactive about helping enrollees navigate the unwinding process and some states are experiencing less unwinding effects because they simply do not offer comprehensive Medicaid coverage under the Affordable Care Act, and so they have less of a population that could potentially drop off the rolls,” Saloner said.
What People Are Saying
Brendan Saloner, professor of health services, policy, and practice at the Brown University School of Public Health, told Newsweek: “There is a well established relationship between losing coverage and experiencing disruptions in care. Practically, this can mean avoiding or delaying care, not filling prescriptions, and even showing up more at the emergency room because a health condition is not adequately managed in primary care.
“Even if we do not immediately see widespread health impacts, there are cumulative effects to keeping kids off health insurance. We see some of these negative effects showing up later in adolescence and young adulthood, for example because of less preventive health care. The apparent savings from not covering low-income children can result in even larger long-term costs from preventable chronic disease, which is penny wise, pound foolish.”
What Happens Next
As the unwinding continues, more reductions in enrollment are expected in Texas and across the country.