The number of children kicked off Medicaid since states began checking the eligibility of beneficiaries six months ago is likely higher than 2 million, because not every state reports by age.

In the 19 states that do report by age, children accounted for more than 4 in 10 Medicaid disenrollments.

When the Biden administration allowed states to begin the “unwinding” process, officials estimated about 15 million people would lose coverage. Since the process started April 1, the U.S. is more than halfway to that mark.

Some people who lose coverage end up moving to private insurance plans or the Affordable Care Act exchange, but the full impact won’t be known until more data is available, likely from national health coverage surveys next year.

Most people have been removed for “procedural” reasons, like missing or incorrect paperwork, or when the state has outdated contact information, even though they may still be eligible. Across all states, 72 percent of people disenrolled were for procedural reasons.

The Centers for Medicare and Medicaid Services has expressed concern for months that many states are rushing through the process, but the administration has largely tread lightly.

This week, Arkansas finished its speed run through the redetermination process. The Biden administration gave states a year, but Arkansas passed a law requiring it to finish in six months. About 427,000 people lost coverage; 77 percent were because of procedural reasons. 

Before the pandemic, people churned in and out of Medicaid for various reasons. Participants lost their coverage if they earned too much or didn’t provide the information needed to verify their income or residency.

But during the public health emergency period, income changes or missed paperwork didn’t matter. If someone was enrolled in Medicaid in March 2020, or if they became eligible at any point during the pandemic, they remained eligible the entire time.

As a result, Medicaid enrollment grew more than 30 percent and covered more than 90 million people. 

But Congress ended those protections, and states have been able to reassess eligibility and kick people off Medicaid rolls since April.