Around 1.6 million Americans lost coverage under the federal Medicaid program in the first six months of President Donald Trump’s second term, according to data compiled by health policy nonprofit KFF.
These removals are part of the broader “unwinding” of Medicaid that followed the COVID-19 pandemic, during which former President Joe Biden temporarily expanded access to the program to help Americans maintain health coverage during the public health emergency.
The Centers for Medicare and Medicaid Services (CMS) told Newsweek it was “committed to protecting the most vulnerable Americans while strengthening the long-term stability of Medicaid, lowering health care costs for families, and giving states the flexibility they need to design Medicaid programs that best serve their communities.”
Why It Matters
Although the 1.6 million disenrollments stem from a process that has been underway since March 2023, concern is mounting about what happens next. The Medicaid unwinding is coinciding with significant upcoming changes to federal health programs, including cuts to Medicaid and shifts in Affordable Care Act (ACA) subsidies scheduled for next year.
Under Trump’s proposed “One Big Beautiful Bill,” roughly $1 trillion in Medicaid cuts are anticipated. The Congressional Budget Office (CBO) has projected that such reductions could push millions more off the program, and experts warn that new work requirements and related administrative hurdles could cause even more people to lose coverage.
At the same time, a policy first enacted under former President Barack Obama—expanded tax credits that made ACA marketplace plans more affordable—is set to expire, with the Trump administration opting not to renew the enhanced ACA subsidies.
The end of these enhanced tax credits is expected to drive up national average premiums for ACA plans by about 20 percent. People working for small businesses, retirees and students are among those likely to feel the impact most sharply.
What To Know
During the Biden administration, many states broadened Medicaid eligibility to shield low-income and vulnerable residents during the COVID-19 emergency. Enrollment swelled from roughly 64.5 million people in February 2020 to 87 million by March 2023.
Federal rules allowed states to begin removing people who gained coverage under this expansion only after March 2023. As states have resumed normal eligibility checks, the unwinding process has triggered large declines in Medicaid enrollment.
When Trump began his second term in January 2025, 72,011,017 Americans were enrolled in Medicaid. By July 2025, that figure had dropped to 70,356,307.
Even without future Medicaid cuts or higher ACA premiums, experts have been uneasy about the unwinding, warning that more uninsured Americans could lead to worsening health outcomes nationwide.
Still, the data so far is somewhat mixed. Lindsey Leininger, a professor of business administration and director of the Center for Health Care at Dartmouth College, told Newsweek that the overall increase in the uninsured population from the unwinding has been “modest so far,” suggesting that many people have been able to secure other forms of coverage.
She noted that Medicaid enrollment “has fallen from its pandemic-era peak, but it remains almost 10 percent higher than before the pandemic,” adding that these trends “offer reassurance.” At the same time, she emphasized that the national picture masks steep declines in some places: “Several states have experienced very large enrollment declines, in some cases as much as 15 percent below pre-pandemic levels,” she said. While state-level data on how those drops translate into uninsured rates is not yet available, she added, “it is hard to believe they did not leave more people uninsured.”
