2 million fewer kids have Medicaid since Trump took office — and it's about to get worse

The number of young children without health insurance in the US rose sharply between 2022 and 2024 and is set to continue surging as the Trump administration implements work reporting requirements and other changes expected to kick millions—adults and kids—off Medicaid.

A report published Monday by the Center for Children and Families (CCF) at Georgetown University’s McCourt School of Public Policy found that nearly 220,000 additional children under the age of six were uninsured in 2024, a 23% increase from 2022. During that period, the total share of young children without health insurance rose to 5.3%—the highest rate in almost a decade.

The new report argues the rising uninsured rate among young children is “at least in part” attributable to the unwinding of pandemic-era protections that allowed people to remain on Medicaid without undergoing routine eligibility checks. The analysis found that Texas, Florida, and Georgia accounted for more than half of the increase in young children without insurance between 2022 and 2024.

Elisabeth Wright Burak and Aubrianna Osorio, researchers at CCF, wrote that “these data provide a major warning sign for what’s to come, as states grapple with the onslaught of Medicaid cuts from [the 2025 Republican budget law] and new coverage restrictions.”

“One in 4 children in the US have at least one parent who was born abroad,” the researchers wrote. “For these children, the vast majority of whom are citizens, harsh anti-immigration policies and rhetoric are already leading to missed doctor appointments, on top of the ongoing fear, uncertainty, and overall stress that can compromise healthy development of young children. Fears of safety and separation have made more parents afraid to enroll their eligible, citizen children in programs like Medicaid and [Supplemental Nutrition Assistance Program], exposing children and families to additional financial risk and food insecurity.”

“Many more parents of young children enrolled in Medicaid themselves will be at higher risk of losing coverage as work reporting requirements and added red tape come along in 2027,” they added. “We know as parents lose coverage, their children are also at grave risk of losing access to health care through the ‘unwelcome mat’ effect.”

CCF’s report came as the Trump administration rolled out a new rule that will dictate how states implement Medicaid work reporting requirements included in the 2025 Republican budget law, which contains around $900 billion in cuts to Medicaid over the next decade.

Advocates warned the rule will result in millions of people, including many children, losing coverage by creating onerous bureaucratic barriers to obtaining and keeping Medicaid coverage. CCF estimated last week that, as of April 2026, roughly 2 million fewer children were enrolled in Medicaid and the Children’s Health Insurance Program compared to January 2025, the start of President Donald Trump’s second White House term.

“This is terrible news because when child enrollment in Medicaid and CHIP goes down, the child uninsured rate goes up,” wrote Joan Alker, CCF’s executive director. “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 income eligibility levels did not change and the unemployment rate has been inching upward since President Trump took office.”