Texas removed over 1 million children from the state’s Medicaid and Children’s Health Insurance Program (CHIP) over the course of two years, according to data from the Kaiser Family Foundation. (1) More than 1 in 4 (27%) of children were disenrolled between March 2023 and June 2025.
During the COVID-19 pandemic, states were required by federal rules to keep Medicaid recipients continually enrolled, even if their eligibility status changed. That mandate expired in March 2023, allowing states to remove individuals from the program once again.
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But while enrollment numbers have dropped nationwide — some states have higher rates of disenrollment — Texas leads the way in individuals rolled off by a country mile (nearly 1.8 million total).
There may be more to come, as even more Americans are poised to lose health coverage following the enactment of President Donald Trump’s “One Big Beautiful Bill.”
What does this mean for families?
It’s unknown if any of the over 1 million disenrolled Texas children were able to access another form of health insurance. Some may have found alternative access, such an employer-sponsored plan through their parents, while others may “remain uninsured for long periods of time,” Brendan Saloner, a professor of health services, policy and practice at Brown University, told Newsweek. (2)
The state’s Health and Human Services Commission (HHSC) told the publication: “If HHSC determines that an individual is ineligible for Medicaid or CHIP, HHSC transfers that individual’s account information to the Marketplace to be assessed for eligibility for other health care coverage programs.”
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Saloner noted “there is a well established relationship between losing coverage and experiencing disruptions in care. Practically, this can mean avoiding or delaying care, not filling prescriptions, and even showing up more at the emergency room because a health condition is not adequately managed in primary care.
“Even if we do not immediately see widespread health impacts, there are cumulative effects to keeping kids off health insurance.”
A lack of preventive care early in childhood could result in more health incidents later in life. Increased development of chronic illnesses can result in higher lifetime costs for both families and states.
How to prepare if your child is disenrolled
Health care costs for children can be a substantial burden for families, and being disenrolled from insurance can incur financial stress. What options do you have if your child gets disenrolled, and how can you prepare for future costs?
In the event your child gets disenrolled from Medicaid or CHIP, they may be able to reapply. If they are not reapproved, they may be able to apply for a new plan on the HealthCare.gov Marketplace as early as 60 days before their coverage ends. According to a Forbes Advisor analysis of Marketplace rates, child-only health insurance costs an average of $336 a month for a child under 15 and $397 for an 18-year-old. (3) If you have a lower income and your child is enrolled through a Marketplace plan, you may qualify for a tax credit to lower monthly premiums.
If you find yourself in an insurance gap for your child, locate sliding-scale or free clinics and negotiate payment plans in the event of a hospital visit.
If you are still covered, make sure to keep up with all renewal dates and deadlines and also monitor your household’s income changes, which can affect your eligibility.
And whether or not you have reliable health insurance for your children, consider building up an emergency fund as best you can to cover copays, out-of-pocket costs and funds to cover months they might be uninsured.
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Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
Kaiser Family Foundation (1); Newsweek (2); Forbes Advisor (3)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.