Indiana Medicaid Enrollment Has Fallen Sharply. What the Numbers Do—and Do Not—Show
Indiana’s Medicaid and CHIP enrollment has continued to decline well after the state completed its scheduled post-pandemic “unwinding” period in March 2024. The CMS snapshot counted 1,378,365 Indiana Medicaid/CHIP enrollees in May 2026, including 652,866 children and CHIP enrollees.
Those figures show a major change in enrollment. They do not, however, show how many individual Hoosiers lost coverage, how many found other insurance, how many later returned to Medicaid, or how many became uninsured.
That distinction is especially important when interpreting the data.
A large decline in enrollment counts
Indiana reported 2,197,832 Medicaid beneficiaries immediately before unwinding, in a baseline report dated February 28, 2023. Indiana began post-COVID Medicaid redeterminations in April 2023 and reported completing its scheduled 12-month unwinding period in March 2024.
CMS reported 1,378,365 Indiana Medicaid/CHIP enrollees in May 2026: 652,866 child-and-CHIP enrollees and 725,499 adult Medicaid enrollees.
The difference between the pre-unwinding baseline and the May 2026 count is roughly 819,000. But these are non-comparable, point-in-time administrative enrollment counts. They are not a count of 819,000 unique disenrollments, and they do not establish how many people became uninsured.
Enrollment can change for many reasons. Available evidence indicates Indiana’s decline reflects a mixture of post-pandemic redeterminations, income or eligibility changes, procedural closures, pending renewals, and some coverage or program transitions. The public evidence does not quantify every category statewide.
CMS also reported a 1% one-month decline in both Indiana’s total Medicaid/CHIP enrollment and its child-and-CHIP enrollment in May 2026.
Children account for a substantial part of the visible decline
CMS reported 817,040 Indiana child-and-CHIP enrollees in April 2025 and 652,866 in May 2026. That is a point-in-time decline of about 164,174.
It is not a count of unique children who lost coverage, and it does not show how many became uninsured.
Independent analysis from Georgetown University’s Center for Children and Families similarly estimated that about 174,000 fewer Indiana children were enrolled in Medicaid/CHIP in April 2026 than in January 2025, a decline of roughly 20%. That estimate corroborates a major enrollment decline, but it does not identify each child’s outcome, reason for leaving enrollment, or insurance status afterward.
The available public record does not establish what share of disenrolled children obtained CHIP, employer-sponsored insurance, Marketplace coverage, another Medicaid category, or became uninsured.
Continuous eligibility does not eliminate annual renewals
Since January 1, 2024, children under 19 who are determined eligible for Indiana Medicaid have received 12 months of continuous eligibility, subject to limited exceptions.
Continuous eligibility is not a guarantee that a child can never leave Medicaid during that period, and it does not eliminate annual renewal activity.
Because of this 12-month policy, large child enrollment losses should not be attributed to routine midyear income changes. The available data do not show how many child enrollment changes occurred at annual renewal, through permitted exceptions, through aging or category changes, or through data and program transitions.
Potential reasons for child enrollment declines include annual redeterminations, aging or category changes, moves, voluntary withdrawals, death, and data or program transitions. The evidence does not quantify the share attributable to each reason.
May renewal data show a high procedural-closure rate
One CMS renewal cohort offers a closer look at what happened during May 2026, although it should not be used as a measure of all statewide enrollment losses or all renewal outcomes over 2025 and 2026.
For Indiana’s May 2026 renewal cohort, CMS reported:
- 98,256 people were due for renewal.
- 16% were renewed.
- 47% were disenrolled.
- 37% were still pending.
CMS reported that procedural or administrative disenrollments represented 46% of the full May cohort and about 98% of that month’s reported disenrollments. Applying the rounded 46% rate to the cohort produces an approximate figure of 46,000 procedural or administrative disenrollments.
A procedural closure means coverage ended for an administrative or process reason rather than after a completed-form finding that the person was ineligible. It does not, by itself, establish that the person remained eligible or that the closure was improper.
Indiana’s 46% procedural-discontinuance rate was at the high end of the 4% to 46% state range CMS reported for May 2026. That is an important warning sign about the renewal process, but it remains a single-month cohort statistic—not an estimate for the entire state, the full post-unwinding period, or every enrollment loss.
The available public record also does not establish what share of 2025–26 procedural closures resulted in reinstatement within 30, 60, or 90 days.
Operational indicators show friction, not proof of systemic failure
CMS reported several May 2026 operational measures for Indiana:
- A 16-minute call-center wait.
- A 19% call abandonment rate.
- 4% of MAGI applications taking longer than 45 days.
Together with the procedural-closure and pending-renewal figures, these measures are consistent with significant access or processing friction. They do not establish unlawful conduct, categorical system failure, or the number of eligible people who may have been improperly terminated.
The application-timeliness figure has a further limit: application-processing data do not measure renewal processing. It therefore cannot determine whether improper renewal closures occurred.
CMS sent Indiana a monitoring letter in May 2023 emphasizing timely application processing and continued review of call-center, renewal-outcome, and processing-timeliness data. That letter provides context for the kinds of operations CMS was monitoring; it does not settle what caused later enrollment changes.
One unresolved question is why Indiana’s May 2026 ex parte renewal rate was 7%, compared with 48% nationally. The available public record does not explain Indiana’s reported rate.
What protections were documented during unwinding
During the 2023–24 unwinding, Indiana’s Family and Social Services Administration reported advance outreach, redetermination notices mailed 45 days before due dates, multiple outreach channels, and a 90-day reconsideration period for late renewal submissions.
Those documented steps show that Indiana had some continuity protections during unwinding. They do not establish how effectively those protections operated in 2025–26 or whether they prevented improper closures.
FSSA policy-manual materials also document changes involving redetermination mailers and income verification in February 2026, along with continuing revisions involving child continuous eligibility in 2025–26. The indexed change list does not explain the enrollment decline or establish that any listed change caused it.
Disaster declarations did not document broad renewal relief
Indiana had disaster declarations in 2026, including Governor Braun’s June 19 emergency declaration covering 63 counties after severe weather from June 9 through June 18. Indiana also had a federal emergency declaration after flooding beginning August 11, 2026.
Indiana policy permits residence in a disaster-declared county to excuse a HIP six-month penalty or lockout associated with required POWER-account contributions. That documented exception is narrow. It is not a general Medicaid renewal extension, a moratorium on disenrollments, or blanket protection from renewal-related coverage loss.
The reviewed primary materials did not identify a statewide or disaster-county suspension or extension of ordinary Medicaid renewals, or a broad halt to disenrollments, during the 2026 disaster declarations.
That absence of a located public policy does not establish whether FSSA provided any undocumented or non-public operational accommodation to disaster-affected residents.
What the public data still cannot answer
The available public evidence documents a large continuing enrollment decline and a high May 2026 procedural-closure rate. It does not answer several questions that would be necessary to determine the real-world coverage outcomes for individual families.
No audited public statewide dataset was identified that links each procedural closure to reinstatement, other coverage, or uninsured status. Nor does the available record fully separate closures, transfers, reapplications, and reenrollments by age and county.
As a result, the evidence supports concern about enrollment losses and renewal-process friction. It does not support treating enrollment declines as a count of people who became uninsured, or treating each procedural closure as proof of agency error or continued eligibility.
