Nearly 1.8 million Texans have lost Medicaid coverage over the past two years, according to data from KFF, a nonpartisan health policy organization. The disenrollments are part of a nationwide “unwinding” process following the expiration of COVID-era Medicaid expansions.
During the pandemic, federal rules prevented states from removing people from Medicaid—even if their eligibility changed. That protection ended in March 2023, triggering a mass review of recipients’ eligibility across the country.
A spokesperson for the Texas Health and Human Services Commission (HHSC) told Newsweek that the agency remains committed to ensuring qualified Texans retain their benefits. “Redetermining eligibility within federal requirements was a massive undertaking,” the spokesperson said, noting that Texas had to evaluate the eligibility of more than 6 million people within a 12-month window.
Why It Matters
The post-pandemic rollback has caused sharp drops in Medicaid enrollment nationwide. While some who lost coverage may have secured private insurance through jobs or the ACA Marketplace, many remain uninsured—raising alarms among public health experts. States with high poverty rates and lower rates of employer-sponsored coverage, like Texas, are especially vulnerable.
In March 2023, Texas had just under 6 million Medicaid enrollees. By March 2025, that number had dropped to 4.16 million—a loss of 1.76 million people. This 30% decline is among the largest in the country and faster than in other large states such as Florida, California, and New York.
What Experts Are Saying
Timothy McBride, a public health professor at Washington University in St. Louis, said the steep decline is partly due to Texas’ high reliance on Medicaid coverage during the pandemic and a lower prevalence of private or employer-provided insurance.
“Texas, along with Florida, California, and New York, made up a significant chunk of Medicaid enrollment before the unwinding began,” McBride said. “That’s because of high poverty rates, fewer quality jobs with benefits, and a higher percentage of nonwhite residents who rely on public health programs.”
McBride expressed concern about the potentially large number of Texans left uninsured. “I worry about delays in necessary medical care, worsening chronic conditions, increased mental health issues, and rising medical debt,” he said. He estimated that about 30% of those who lost Medicaid may now be uninsured—many of them children.
Laura Dague, a health policy professor at Texas A&M University, said the long-term impact depends on how aware people were of their Medicaid status and how often they relied on it. She also warned of further disruptions ahead, especially as ACA Marketplace subsidies decrease. “Texas has seen major growth in the exchange market in recent years,” Dague noted. “Losing those subsidies could reverse that trend.”
Looking Ahead
As the Medicaid redetermination process continues, additional coverage losses are expected in Texas and across the country. With millions already affected, health officials and experts remain concerned about access to care for low-income families and individuals—especially those who now fall through the cracks of the health care system.
