At least 2 million children from low-income households have lost their Medicaid coverage this year due to the expiration of pandemic-era policies and paperwork issues.

Extra federal funding introduced during Covid provided Medicaid coverage for millions of low-income adults and kids. But since it expired this past March, over 10 million Americans have dropped out.

At least 2 million of those disenrollments are children—a figure that Joan Alker, executive director and research professor at the Georgetown Center, believes will only continue to grow.

Alker told The New York Times that in the coming weeks, the data will likely show 3 million children have lost coverage.

“This is an unprecedented situation,” Alker said, adding that this unwinding of coverage “has the potential to increase the uninsured rate for children by the largest amount that we’ve seen in decades.”

Why are so many children losing coverage?

Georgetown University research shows the number of uninsured children slightly declined during the pandemic after rising steadily for three years.

In fact, between February 2020 and March 2023, Medicaid enrollment ballooned by around 20 million people, thanks to continuous coverage. And as of March, over half of all children in the U.S. were covered by Medicaid or the Children’s Health Insurance Program (CHIP).

KFF researchers estimated in April that 17 million Americans—including 5 million children—would lose coverage after the extra funding expired. But they didn’t anticipate just how dramatically the numbers would plummet in just a matter of months.

It's possibile, of course, that some of these children were no longer eligible for Medicaid because their parents have incomes that now exceed enrollment limits or secured healthcare coverage through an employer.

But about 3 in 4 children who have lost their coverage are actually still eligible, according to Alker.

Georgetown researchers wrote in a recent report that “children are also more likely to be disenrolled for procedural reasons and to experience gaps in coverage before re-enrolling back onto Medicaid.”

Procedural disenrollments can occur when people don’t submit or properly complete their paperwork, or file their renewal packets on time, or when states have outdated contact information.

The Georgetown Center and KFF say 71% of all disenrollments since April were due to procedural reasons.

“Governors who are not paying good attention to this process are dumping a lot of people off Medicaid,” Alker told CBS MoneyWatch, noting disenrollment has become a major issue in states like Texas, which has removed 1.2 million people—58% of whom are children—from its Medicaid rolls.

“There is no reason in the U.S. that children should be uninsured,” she said

Why lapses in coverage are such a big deal

Many families simply can't afford to get their children the care they need without health coverage.

After losing Medicaid, some parents are canceling pediatrician appointments for their kids, while others are struggling to purchase costly medications like inhalers or insulin.

More than 40% of school-age children and adolescents have at least one chronic health condition—such as asthma, obesity, or other physical conditions—and behavior or learning problems, according to the CDC.

Community health centers and even school nurses can provide some support, but they’re also struggling to handle the number of visits.

A survey from the National Association of Community Health Centers found that 85% of the centers said they would face financial and operational strain due to the unwinding of continuous Medicaid coverage.

Lapses in care can worsen medical outcomes, disrupt learning, and strain already struggling low-income households.

“Poor health dur­ing child­hood can affect vir­tu­al­ly every area of a child’s life, includ­ing school per­for­mance, and can have last­ing con­se­quences on health, well-being, and finan­cial secu­ri­ty into adulthood,” says The Annie E. Casey Foundation.

She adds that health coverage also frees up funds for parents to pay for other basic needs, such as food and housing.