by Nearly 700,000 people in Illinois have lost access to Medicaid over the past two years, according to new data from the nonprofit health policy organization KFF. The sharp decline comes as part of a broader nationwide “unwinding” of pandemic-era health coverage expansions.
Why It Matters
The mass disenrollment from Medicaid raises alarms about the growing number of Americans who could now be left without any form of health insurance. While some of those removed may find alternative coverage, many risk losing access to critical health services, potentially leading to:
- Delayed treatment
- Increased emergency room visits
- Higher healthcare costs
- Worsening of chronic and mental health conditions
Health experts warn that such outcomes could strain hospitals and negatively impact public health on a large scale.
Background on Medicaid Unwinding
During the COVID-19 pandemic, the federal government allowed states to expand and maintain continuous Medicaid coverage under emergency provisions in the Affordable Care Act (ACA). States were barred from removing enrollees from Medicaid, even if they became ineligible due to income or other changes.
That changed in March 2023, when federal rules permitted states to begin “unwinding” the pandemic expansions—removing individuals no longer eligible for the program.
In Illinois, Medicaid enrollment dropped from 3,826,461 in March 2023 to 3,146,295 in April 2025, according to KFF. This marks a decline of nearly 700,000 recipients, though current enrollment remains about 7% higher than pre-pandemic levels in February 2020.
What Experts Are Saying
“The unwinding has taken place over a year and Medicaid enrollment is still higher now than in the pre-pandemic period,” said Kathleen Adams, professor of health policy at Emory University.
She added that state-by-state variations have played a key role in how the process has unfolded. Factors include:
- Whether the state had expanded Medicaid under the ACA
- The pace of review and disenrollment
- Recent decisions by some states to expand Medicaid for the first time, which in turn increased enrollment
Looking Ahead
As states continue to assess eligibility and reduce Medicaid rolls, experts are closely watching for the long-term impacts on health outcomes. Concern is growing, especially with the Trump administration’s proposed changes, which include work requirements that could further tighten eligibility.
Without timely access to affordable healthcare, advocates warn that the uninsured population could spike, potentially reversing public health gains made during the pandemic response.
Bottom Line
Illinois’ Medicaid rollback is part of a broader national shift as pandemic-era protections are lifted. With nearly 700,000 people already dropped, the state faces mounting questions about how to ensure its most vulnerable residents aren’t left behind.
