CMS posts claimed September 2025 Medicaid/CHIP enrollment report: 77.1M, down 2.4M since December 2024

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

September 2025 Key Findings

Medicaid and CHIP Enrollment

• In September 2025, 77.1 million individuals were enrolled in Medicaid and CHIP.
• 69.8 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 40.3 million adults were enrolled in Medicaid, and there were 36.7 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in September 2025 of ~77.1 million dropped about 0.9% from July 2025, or by around 700,000 people.

The all-time high enrollment watermark for Medicaid/CHIP was in April 2023, when it officially hit 94.1 million Americans (95.7 million when you include the U.S. territories).

It's important to note that CMS actually has two different reports on Medicaid enrollment: The monthly Medicaid & CHIP Enrollment Trend Snapshot (referenced above) and the Medicaid Budget & Expenditure System (MBES).

Each type of report measures Medicaid enrollment a bit differently:

• The MBES report is 9 months out of date (through March 2025) while the Trend Snapshot is only 3 months out of date (through September 2025).

• The MBES count includes individuals enrolled in limited benefit plans and the Performance Indicator count does not include such individuals.

• The MBES data represents the count of unduplicated individuals enrolled in the state’s Medicaid program at any time during each month in the quarterly reporting period, while the Performance Indicator data captures the count of individuals enrolled on the last day of the month.

• The MBES count only includes individuals whose coverage is funded through Medicaid (title XIX of the Social Security Act), while the published Performance Indicator also includes individuals funded through CHIP (title XXI of the SSA).

• MBES and Performance Indicator data may be derived from different state systems.

• Retroactive state adjustments to MBES or Performance Indicator data may be in progress.

• States have likely generated MBES data and Performance Indicator data from state systems on different dates.

• The other major difference: The MBES reports include Medicaid enrollees in the U.S. territories: American Samoa, Guam, N. Mariana Islands, Puerto Rico and the U.S. Virgin Islands.

The MBES numbers for U.S. territories stood at 1.45 million Medicaid enrollees as of March 2025. If you add those to the Trend Snapshot total for the 50 states +DC, it comes in at 78.55 million as of September 2025.

It's also worth noting that ACA Medicaid Expansion enrollment specifically  was 20.5 million as of March 2025 according to the MBES report, down around 3.5 million from the all-time high it reached in May 2023.

Finally, the summary report mentions in passing that ACA exchange enrollment in Qualified Health Plans (QHPs) was ~22.6 million in September, while Basic Health Plan (BHP) enrollment was still arond 1.8 million.

The 22.6 million figure is noteworthy since it means net attrition of exchange enrollment as of September was only 7% vs. the ~24.3 million who selected exchange QHPs during the 2025 Open Enrollment Period.

Given the circumstances, it's also noteworthy that these numbers are continuing to be officially recognized by the Trump Regime.

As for my concerns about potential manipulation of data by the Musk/Trump Admin, once again I'm still not seeing any obvious red flags. Between December 2024 and August 2025, net Medicaid/CHIP enrollment has dropped by around 2.4 million, or 3.0%, for whatever that's worth.