Medicaid Enrollment Sits at 74.9 Million as of February 2026 — Down 21% From Pandemic Peak, Still Above Pre-COVID Levels

Where the Numbers Stand

As of February 2026, 74.9 million people are enrolled in Medicaid and the Children's Health Insurance Program (CHIP), according to the Kaiser Family Foundation's Medicaid Enrollment and Unwinding Tracker, last updated May 29, 2026.

That's a 21% drop from the March 2023 peak of 94 million — when the COVID-era continuous enrollment provision expired and states were finally allowed to resume checking who actually qualifies.

Enrollment is still 5% higher than it was in February 2020, before any of this started.

What the Unwinding Actually Did

For three years during the pandemic, states were prohibited from disenrolling anyone from Medicaid. Regardless of whether your income changed, whether you got a new job, whether you moved — you stayed on the rolls. The program ballooned from roughly 71 million to 94 million enrollees.

Starting April 1, 2023, states began conducting renewals. Most wrapped up within 12 months. Nearly all states had completed the process by August 2024, according to KFF.

Result: about 19 million people came off the rolls over roughly 18 months.

The Children's Enrollment Wrinkle

While total Medicaid/CHIP enrollment is up 5% from pre-pandemic levels, the number of children enrolled has actually fallen — down 345,000, or 1%, from February 2020 to February 2026, per KFF data.

CHIP exists specifically to cover kids. If the program expanded overall but children's coverage shrank slightly, that's a discrepancy worth examining — and neither left nor right-leaning outlets are making it a headline.

Why Enrollment Is Still Above Pre-Pandemic Levels

KFF identifies several reasons the rolls haven't returned to 2020 baselines.

First, some people who were eligible before the pandemic but never enrolled signed up during the emergency period. Second, states improved their administrative renewal processes during unwinding, which reduced "procedural disenrollments" — people losing coverage not because they're ineligible, but because paperwork fell through the cracks. Third, some states expanded eligibility under the ACA's Medicaid expansion for specific groups since 2020.

Not all of this is bureaucratic bloat. Some of it is the system catching people who were already supposed to be covered.

The Strongest Counterargument

Critics of Medicaid expansion argue the program has grown well beyond its original safety-net mandate, that able-bodied working-age adults with no dependents are being covered at taxpayer expense, and that enrollment 5% above pre-pandemic levels — despite the unwinding — suggests the eligibility verification process still isn't tight enough.

That concern is legitimate. Medicaid is a joint federal-state program funded by taxpayers. If people who are no longer income-eligible remain enrolled due to administrative failures or deliberate process delays, that is a fiscal and fairness problem. The question of whether the current 74.9 million figure represents the truly eligible population or an inflated one remains open.

KFF's data doesn't resolve it. It describes what happened, not whether every remaining enrollee meets the legal eligibility threshold today.

What Mainstream Coverage Is Getting Wrong

Left-leaning outlets have framed the unwinding almost entirely as a coverage-loss story — emphasizing the 19 million disenrollments as harm done to vulnerable people. That's a real concern worth covering. But it assumes everyone who was removed was wrongly removed. Some were legitimately over-income. The data doesn't split those groups cleanly, and most coverage doesn't acknowledge that gap.

Right-leaning outlets, when they cover this at all, tend to focus on the size of the program and spending — but often skip the nuance that some of the post-pandemic enrollment increase reflects genuine eligibility, not fraud or abuse.

The Urban Institute source provided in this research package returned a dead link — a "page not found" error — meaning one potentially useful data point on state-level disenrollment impacts simply isn't available. That's a gap. Readers should know it.

What It Means for You

If you're a taxpayer, you're funding coverage for 74.9 million people — a program that has grown 5% beyond its pre-pandemic size even after the largest disenrollment effort in the program's history.

If you're a state budget director, the federal-state cost-sharing math matters enormously, especially with congressional Republicans actively debating Medicaid work requirements and per-capita caps in 2026 budget negotiations.

If you were one of the 19 million removed, whether that removal was correct depends entirely on your specific situation — and the data, as reported by KFF through February 2026, doesn't tell us how many of those disenrollments were accurate versus procedural error.