Why fewer Texas kids are enrolled in Medicaid
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Large numbers of children — including nearly 191,000 in Texas — are dropping off the Medicaid rolls, even though Congress' Medicaid overhaul didn't change kids' eligibility.
Why it matters: Children without insurance are less likely to receive checkups, preventive care and early treatment, while hospitals face additional strain from caring for more uninsured patients.
State of play: About 2 million fewer kids were enrolled in Medicaid this March than at the start of the second Trump administration, according to the most recent federal data.
- More recent state data analyzed by Georgetown University's Center for Children and Families suggests the decline has continued, executive director Joan Alker says.
- Experts say confusion over new Medicaid work requirements, immigration enforcement and paperwork requirements may be discouraging some families from enrolling eligible children.
- "It's a very unwelcoming climate," Alker says.
What they're saying: Children's hospitals say they're seeing more uninsured children, many of whom remain eligible for Medicaid or CHIP, Aimee Ossman, vice president of policy at the Children's Hospital Association, says.
- Hospitals help eligible uninsured kids enroll in coverage.
Zoom in: Texas had 190,956 fewer children enrolled in Medicaid/CHIP in February 2026 than in January 2025, a 6% drop, according to Georgetown's analysis of state enrollment data.
Between the lines: Texas already had the nation's highest rate of uninsured children before the recent enrollment declines, with an estimated 1.1 million children (14%) lacking health coverage in 2024, according to the KIDS Count Data Book from the Annie E. Casey Foundation.