Millions Lost Medicaid Coverage During Unwinding in 2023

Strategic Insights -

A new study has shed light on the impact of the unwinding of Medicaid's continuous coverage provision, which began in April 2023, and resulted in the disenrollment of over 25 million people. The research, conducted by a team of researchers from Harvard University T.H. Chan School of Public Health, found that the effects on overall insurance coverage, including reenrollment in Medicaid, and the affordability of care remained unclear.

Key Takeaways:

  • Over 25 million people were disenrolled from Medicaid due to the unwinding of the continuous coverage provision, with state-level termination rates ranging from 8.3% to 55.3% of pre-unwinding Medicaid enrollment.
  • Net enrollment decreases, including new and returning enrollees, were smaller, with a median decrease of 13.9% compared to a median termination rate of 26.6%.
  • New applications fell by 29.8% during the COVID-19 pandemic but increased by 29.0% during the unwinding period.
  • Gaps between administratively measured and survey-measured enrollment grew during the pandemic but narrowed during the unwinding period.
  • Survey-reported Medicaid enrollment decreased among women, healthier individuals, young adults, recently pregnant adults, and White individuals during the unwinding period.
  • Changes in uninsurance overall were modest but rose significantly among healthier individuals.
  • Cost-related barriers to care rose among White individuals, college-educated individuals, and healthier individuals.

Statistics:

  • 25 million people were disenrolled from Medicaid due to the unwinding of the continuous coverage provision.
  • State-level termination rates ranged from 8.3% to 55.3% of pre-unwinding Medicaid enrollment.
  • Net enrollment decreases, including new and returning enrollees, were 13.9%.
  • New applications fell by 29.8% during the pandemic but increased by 29.0% during the unwinding period.

Sources:

  • NewsRx. Research Data from Harvard University T.H. Chan School of Public Health Update Understanding of COVID-19 (US Coverage Changes During Medicaid Unwinding in 2023). Managed Care Weekly Digest. October 20, 2025; p 165.
  • US Coverage Changes During Medicaid Unwinding in 2023. Jama Health Forum, 2025;6(10).