Nearly 2.5 million children in the United States have lost Medicaid or Children's Health Insurance Program coverage since January 2025, according to data published on September 1, 2026 by the Georgetown University Center for Children and Families.
No state has shed a larger share of its kids than Indiana.
And the part that should worry everyone: none of this is the 2025 budget bill's Medicaid cuts. Those have not started yet.
What has already happened
Georgetown's researchers have been tracking child enrollment state by state since the start of Trump's second term. Their June 2026 report found Indiana at the top of the list — an enrollment decline of 19.8%, or over 174,000 children, comparing April 2026 to January 2025. By the data released this week, Indiana's drop had passed 23%.
Five states have now seen declines of 10% or more. Ten states — California, Texas, Indiana, Florida, Georgia, Illinois, Ohio, Arizona, Virginia and Kentucky — account for two thirds of the losses. In the June report, only two states in the country were holding steady or rising.
Georgetown's own words on the timing:
"these enrollment losses are occurring BEFORE Medicaid cuts associated with H.R. 1 are coming into play, which is alarming as more declines will be on the way."
The causes Georgetown lists are paperwork and fear: more red tape and less help getting through it, anti-immigrant policies producing a chilling effect on families whose children are citizens, federal coverage protections that are not being enforced, state eligibility systems making mistakes, and families who assume the cuts are already in force and do not renew.
Joan Alker, who directs the Georgetown center, put the consequence simply: "when Medicaid child enrollment declines, the number of uninsured kids typically goes up."
Paperwork is the mechanism, and it is not an accident
This is the part that gets lost when people argue about eligibility rules. Nowhere in its list of likely causes does Georgetown say these children were found ineligible. Every item on that list is about the process, not about whether a child qualifies.
Eileen Appelbaum of the Center for Economic and Policy Research says the same thing will happen when the new federal rules start next year: "The best guesses from the experts are that two-thirds of the people that will be disqualified will actually be eligible, but they just couldn't handle the paperwork."
Brown University epidemiologists Abdullah Shihipar and Brandon DL Marshall put it in the terms that matter to a family: "Paperwork here is not merely an annoyance, it is a matter of life or death for millions with Medicaid coverage."
A child who loses coverage does not stop getting sick. The asthma inhaler, the ear infection, the well-child visit that catches something early — those either get paid for out of pocket, or they do not happen.
What Indiana's members of Congress voted for
Indiana is already the worst in the country at this, and every Republican it sends to the U.S. House voted to make the national version harder.
On July 3, 2025, the House voted on final passage of H.R. 1, Trump's budget bill. The clerk's roll call records all seven Indiana Republicans voting aye:
That law cuts an estimated $900 billion from Medicaid over ten years. It also does nationally, starting next year, the same kind of thing Georgetown says is already pulling Indiana's rolls down — a 2025 state law that "added additional red tape and reporting requirements." H.R. 1 doubles how often people have to re-prove eligibility, from once a year to twice, and adds an 80-hour-a-month work or volunteer reporting requirement for certain adults.
Indiana has spent the last year and a half running a live demonstration of what happens when you add paperwork to children's health coverage. Its answer was 174,000 kids. Its congressional delegation voted to add more of it, nationwide.
They were told
This is not hindsight. The scale of the Medicaid cuts in H.R. 1 was public before the vote, and it has been the single most-covered consequence of that bill since.
Missouri's Mark Alford voted for the bill in July 2025, then introduced legislation eight months later to keep rural hospitals open — a bill with three cosponsors that has never moved. Kansas Sen. Roger Marshall, an OB/GYN, told a reporter "there are no Medicaid cuts" and called the opposite claim a lie, with his state projected to lose $3.9 billion.
The Indiana seven are on the same roll call. What is different in Indiana is that the state has already produced the number, before the law they passed has done anything at all.
What the record shows
Nearly 2.5 million American children have lost Medicaid or CHIP coverage since January 2025, and Indiana has lost a larger share of its children than any other state — more than 174,000 of them as of April 2026, driven by red tape, fear and confusion rather than by anyone being found ineligible. All of that happened before the Medicaid cuts in the 2025 budget bill took effect. All seven Indiana Republicans in the U.S. House voted for that bill, which cuts $900 billion from Medicaid and doubles how often families must re-prove they qualify.
Source
"Nearly 2.5 Million Children Have Lost Medicaid and CHIP—So Far—During Trump's Second Term", Common Dreams, September 1, 2026. State data: Georgetown University Center for Children and Families, "Which States Are Seeing the Largest Declines in Child Medicaid/CHIP Enrollment?", June 10, 2026. Vote record: U.S. House Clerk, Roll Call 190, July 3, 2025.
