Medicaid Recipients in the US 2026 total 73.2 million people enrolled in Medicaid and CHIP as of June 2026, down from about 79.5 million in December 2024. Adults make up roughly 38.5 million of that total, children account for 47.9% of enrollment, and new work requirements for expansion adults take effect on January 1, 2027.
Medicaid Recipients in the US 2026
Medicaid Recipients in the US 2026 are the people enrolled in Medicaid or the Children’s Health Insurance Program, known as CHIP, in all 50 states and the District of Columbia. The Centers for Medicare & Medicaid Services counted 73,167,389 of them in June 2026. Of that total, 65,969,381 people held Medicaid coverage and 7,198,008 held CHIP coverage. Enrollment peaked near 94 million in April 2023, when pandemic-era rules kept people covered without yearly eligibility checks. Those protections ended, and the rolls have fallen almost every month since.
The decline did not stop after the pandemic unwinding finished. Enrollment slid from about 79.5 million in December 2024 to 73.2 million in June 2026, a loss of roughly 6.3 million people in 18 months. CMS also changed how it publishes the numbers. It is phasing out the old Enrollment Trend Snapshot and moving to a new monthly Eligibility Operations and Enrollment Snapshot, so figures in this report come from both formats. The differences are small, but they explain why totals from different months do not always subtract cleanly.
Interesting Facts About Medicaid Recipients in the US 2026
| Fact | Detail |
|---|---|
| Total Medicaid and CHIP enrollment (June 2026) | 73,167,389 |
| Medicaid enrollment (June 2026) | 65,969,381 |
| CHIP enrollment (June 2026) | 7,198,008 |
| Child share of enrollment (June 2026) | 47.9%, or 35,043,634 children |
| Adult Medicaid enrollment (April 2026) | 38.5 million |
| Enrollment peak | About 94 million in April 2023 |
| Enrollment in December 2024 | About 79.5 million |
| States that expanded Medicaid | 41, including D.C. |
| States that have not expanded | 10 |
| Work requirements start date | January 1, 2027 |
Data source: Centers for Medicare & Medicaid Services, Medicaid & CHIP Enrollment Data Highlights (June 2026); KFF Medicaid Work Requirements Tracker.
The table shows a program that is still enormous but shrinking. Medicaid Recipients in the US 2026 outnumber the population of every US state combined except the largest three, and children and adults split enrollment almost evenly. The June figure covers only the states and D.C. that reported data, and it counts people eligible for comprehensive benefits. It leaves out emergency Medicaid, family-planning-only coverage, and limited-benefit dual eligibles.
The gap between the April 2023 peak and today is about 21 million people. Most of that drop came from the unwinding of continuous enrollment, when states resumed eligibility checks after a three-year pause. The newer drop since December 2024 has a different source. Stricter verification, more frequent paperwork, and ongoing procedural disenrollments keep pulling people off the rolls even though no federal work requirement is in force yet.
Medicaid Recipients in the US 2026: Total Enrollment and Monthly Trend
Monthly Medicaid and CHIP enrollment (millions)
Dec 2024 |████████████████████████████████████ ~79.5
Feb 2026 |█████████████████████████████████ 74.9
Mar 2026 |████████████████████████████████ 74.3
Apr 2026 |███████████████████████████████ 73.9
May 2026 |███████████████████████████████ 73.5
Jun 2026 |██████████████████████████████ 73.2
| Month | Total Enrollment | Change From December 2024 |
|---|---|---|
| December 2024 | About 79.5 million | Baseline |
| February 2026 | 74.9 million | About -4.6 million |
| March 2026 | 74.3 million | About -5.2 million |
| April 2026 | 73.9 million | About -5.6 million |
| May 2026 | 73,526,272 | About -6.0 million |
| June 2026 | 73,167,389 | About -6.3 million |
Data source: Centers for Medicare & Medicaid Services, Enrollment Trend Snapshot and Eligibility Operations and Enrollment Snapshot; ACA Signups analysis of CMS releases.
Every month in this table sits below the one before it. February 2026 came in at 74.9 million, and by June the count had fallen to 73.2 million. CMS reported that April alone dropped about 0.5%, or roughly 398,000 people, from March. The total loss since December 2024 works out to about 8% of the baseline. December 2024 is an approximate figure derived from CMS releases, and the newer May and June counts come from the reformatted snapshot, so treat the cumulative column as a close estimate rather than an exact ledger.
The steady slope matters more than any single month. A loss of roughly 400,000 to 600,000 people a month, sustained across a year and a half, points to structural causes and not a one-time event. States are running tighter renewals, and people who miss a mailed notice lose coverage even when they still qualify. Analysts who track the unwinding call these procedural disenrollments, and children and low-income adults are the groups most often caught by them.
Medicaid Adults vs Children 2026: Enrollment Split by Age Group
Adult vs child enrollment, Feb to Apr 2026 (millions)
Adults, Feb |████████████████████████████████████ 39.2
Adults, Apr |███████████████████████████████████ 38.5
Children, Feb |████████████████████████████████ 35.7
Children, Apr |███████████████████████████████ 35.4
| Metric | Adults | Children (Medicaid + CHIP) | Total |
|---|---|---|---|
| February 2026 | 39.2 million | 35.7 million | 74.9 million |
| March 2026 | 38.7 million | 35.6 million | 74.3 million |
| April 2026 | 38.5 million | 35.4 million | 73.9 million |
| Change, Feb to Apr | -0.7 million (-1.8%) | -0.3 million (-0.8%) | -1.0 million (-1.3%) |
| June 2026 child enrollment | N/A | 35,043,634 | 47.9% of all enrollment |
Data source: Centers for Medicare & Medicaid Services, Enrollment Trend Snapshot (February to April 2026); Medicaid & CHIP Enrollment Data Highlights (June 2026).
Adults are losing coverage faster than children. Adult enrollment fell from 39.2 million in February to 38.5 million in April, a decline of 1.8%. Child enrollment, which combines children in Medicaid with everyone in separate CHIP programs, fell from 35.7 million to 35.4 million, a decline of 0.8%. Adults lost more than twice the share that children lost in the same two months. Adults face more paperwork, more income volatility, and no automatic protection like the continuous-eligibility rules many states apply to young children.
Children still make up nearly half the program. The June count of 35.04 million children represents 47.9% of all Medicaid and CHIP enrollment. States define “child” differently in their state plans, so the age cutoff varies by state, and the total includes every child in a separate CHIP program. The adult category includes pregnant women, parents, people with disabilities, and the expansion population of childless adults under 138% of the federal poverty level.
Medicaid vs CHIP Enrollment 2026: Program Breakdown
June 2026 program split (millions)
Medicaid |███████████████████████████████ 65.97 (90.2%)
CHIP |█████ 7.20 ( 9.8%)
| Program Metric | June 2026 Figure |
|---|---|
| Total Medicaid and CHIP enrollment | 73,167,389 |
| Medicaid enrollment | 65,969,381 (90.2%) |
| CHIP enrollment | 7,198,008 (9.8%) |
| Children in Medicaid or CHIP | 35,043,634 (47.9%) |
| CHIP ever enrolled during the year (SEDS) | More than 7.6 million |
Data source: Centers for Medicare & Medicaid Services, June 2026 Medicaid & CHIP Enrollment Data Highlights; CHIP Statistical Enrollment Data System.
Medicaid carries the overwhelming share of the load. Of the 73.2 million people enrolled in June, 65.97 million, or 90.2%, held Medicaid coverage, and 7.20 million, or 9.8%, held CHIP coverage. CHIP covers children in families that earn too much for Medicaid but cannot afford private insurance, and each state sets its own income ceiling. Medicaid covers a far wider group: low-income adults in expansion states, parents, pregnant women, seniors who need long-term care, and people with disabilities.
The CHIP numbers come with a measurement warning. The monthly count of 7.20 million is a point-in-time snapshot of who is enrolled on the last day of the month. The separate annual SEDS report counts everyone who was ever enrolled at any point in the year, and it exceeds 7.6 million. Neither number is wrong. The larger annual figure shows how many children cycle through CHIP over twelve months, while the monthly figure shows how many hold coverage on a given day.
Medicaid Expansion States 2026: 41 Expansion States vs 10 Holdouts
State Medicaid expansion status, 2026
Expanded (incl. D.C.) |██████████████████████████████ 41
Not expanded |██████████ 10
| Expansion Metric | 2026 Detail |
|---|---|
| States that expanded Medicaid (including D.C.) | 41 |
| States that have not expanded | 10 |
| Expansion income limit | 138% of the federal poverty level |
| Income limit for a single adult (2025 guidelines) | $21,597 |
| States required to apply work requirements | 44, including D.C. |
| Non-expansion states with waiver programs covered by the rule | Georgia, Tennessee, Wisconsin |
| Expansion states with waiver programs covered by the rule | Hawaii, Massachusetts, New York, Oregon, Utah |
Data source: Centers for Medicare & Medicaid Services; KFF Medicaid Work Requirements Tracker (2026).
The Affordable Care Act let states extend Medicaid to nearly all adults with income up to 138% of the federal poverty level, which equals $21,597 for a single person under the 2025 guidelines. 41 states, counting D.C., have taken that option. 10 states have not, and adults in those states who earn too little for marketplace subsidies but too much for traditional Medicaid fall into a coverage gap. Expansion status shapes everything about who counts among Medicaid Recipients in the US 2026, because the childless adults who gained coverage under expansion are also the group the new work rules target.
Expansion status also drives uninsured rates. Income is the strongest predictor of coverage, and state Medicaid policy decides where the line falls. A breakdown of health insurance by income in the US shows that adults in expansion states are uninsured at roughly half the rate of adults in non-expansion states. CMS counts 44 states, including D.C., as subject to the federal work requirement in 2027, which covers all 41 expansion jurisdictions plus three non-expansion states with existing waiver programs.
Medicaid Work Requirements 2026: What Starts January 2027
CBO and CMS coverage-loss estimates from work requirements (millions)
People subject to the rule (CBO) |██████████████████ 18.5
Lose coverage, long run (CBO) |██████ 5.2
Disenrolled in FY 2027 (CMS rule) |██ 2.3
Disenrolled in later years (CMS rule) |████ 3.2
| Work Requirement Metric | Detail |
|---|---|
| Federal start date | January 1, 2027 |
| Hours required | 80 hours per month of work, school, training, or community service |
| Adults covered | Expansion adults ages 19 to 64 |
| People subject to the rule (CBO) | About 18.5 million |
| People projected to lose coverage (CBO) | About 5.2 million |
| CMS projection, fiscal year 2027 | About 2.3 million disenrolled |
| CMS projection, later years | 3.1 to 3.3 million disenrolled |
| Federal savings from work requirements (CBO) | $326 billion over 10 years |
| Eligibility redeterminations for expansion adults | Every 6 months, starting in 2027 |
Data source: Congressional Budget Office; Centers for Medicare & Medicaid Services interim final rule (June 2026); KFF.
The One Big Beautiful Bill Act, signed on July 4, 2025, requires states to condition Medicaid eligibility for expansion adults on meeting work rules starting January 1, 2027. Enrollees must show 80 hours a month of employment, education, a work program, or community service. States can apply for a delay of up to two years if they show a good-faith effort to comply, though federal officials have signaled they may reject postponement requests. CBO projects that about 18.5 million people will fall under the rule and that about 5.2 million will lose coverage as a result.
CMS published its own projection in its June 2026 interim final rule, and the number is lower. The agency expects about 2.3 million people to lose Medicaid in fiscal year 2027, growing to between 3.1 and 3.3 million in later years. Both estimates agree on the mechanism. Research on the Arkansas experiment found that most people who lost coverage were working or exempt but could not document it. Anyone tracking the risk of a rising uninsured population can compare these numbers with data on Americans without health insurance, since coverage losses from Medicaid feed directly into the uninsured count.
Medicaid Coverage Loss Projections 2026: CBO Estimates Through 2034
CBO projected coverage loss by 2034 (millions)
Health provisions of the 2025 law |█████████████████████████ 11.8
Marketplace rule and expired credits |████████ 5.1
Combined total |█████████████████████████████████████ 16.9
| Projection Metric | CBO Estimate |
|---|---|
| People losing coverage from the law’s health provisions by 2034 | 11.8 million |
| Additional losses from the 2025 marketplace rule and expired ACA credits | 5.1 million |
| Combined coverage loss | 16.9 million |
| Loss from work requirements alone | About 5.2 million |
| Federal Medicaid savings from work requirements | $326 billion over 10 years |
Data source: Congressional Budget Office estimates as summarized by the Association of State and Territorial Health Officials and KFF.
The Congressional Budget Office estimates that the health provisions of the 2025 reconciliation law will leave 11.8 million more people without coverage by 2034. Two policy changes outside the law add another 5.1 million: the final 2025 CMS marketplace rule and the expiration of the enhanced ACA premium tax credits. Together that produces a projected 16.9 million drop in coverage. Work requirements account for the largest single slice of both the coverage loss and the federal savings, at $326 billion over ten years.
These are projections, not counts, and actual outcomes depend on how states run the new systems. States can slow losses by expanding automatic eligibility checks that use existing data, which spares enrollees from filing paperwork. Marketplace shifts already show the pressure building on the other side of the coverage system. The latest ACA enrollment statistics show marketplace plan selections falling to 23.1 million in 2026, so people who lose Medicaid have fewer affordable alternatives than they did two years ago.
Frequently Asked Questions
How Many People Are on Medicaid in the US in 2026?
73,167,389 people were enrolled in Medicaid and CHIP as of June 2026, according to CMS. Of that total, 65,969,381 held Medicaid coverage and 7,198,008 held CHIP coverage.
How Many Adults Are on Medicaid in 2026?
Adult Medicaid enrollment stood at 38.5 million in April 2026, down from 39.2 million in February. Adults lost coverage faster than children during that period, with a decline of 1.8%.
How Many Children Are on Medicaid and CHIP in 2026?
35,043,634 children were enrolled in Medicaid or CHIP in June 2026, which represents 47.9% of total program enrollment.
Is Medicaid Enrollment Going Down in 2026?
Yes. Enrollment fell from about 79.5 million in December 2024 to 73.2 million in June 2026, a loss of roughly 6.3 million people. Each monthly CMS report from February through June 2026 showed a lower total than the month before.
How Many States Have Expanded Medicaid in 2026?
41 states, including D.C., have expanded Medicaid to adults with income up to 138% of the federal poverty level. 10 states have not.
When Do Medicaid Work Requirements Start?
Federal work requirements for expansion adults start on January 1, 2027. Enrollees ages 19 to 64 must show 80 hours a month of work, school, training, or community service.
How Many People Could Lose Medicaid Because of Work Requirements?
CBO estimates about 5.2 million people will lose coverage because of work requirements. CMS projected in June 2026 that about 2.3 million people would lose coverage in fiscal year 2027 and 3.1 to 3.3 million in later years.
What Is the Difference Between Medicaid and CHIP?
Medicaid covers low-income adults, children, pregnant women, seniors, and people with disabilities. CHIP covers children in families that earn too much for Medicaid but cannot afford private insurance. In June 2026, Medicaid had 65.97 million enrollees and CHIP had 7.20 million.
What Is the Medicaid Income Limit for Adults in Expansion States in 2026?
Adults in expansion states qualify with income up to 138% of the federal poverty level, which equals $21,597 for a single person under the 2025 poverty guidelines.
Disclaimer: The data research report we present here is based on information found from various sources. We are not liable for any financial loss, errors, or damages of any kind that may result from the use of the information herein. We acknowledge that though we try to report accurately, we cannot verify the absolute facts of everything that has been represented.
