At least 2 million children have lost health insurance coverage since the end of a pandemic policy that guaranteed Medicaid coverage during the health emergency, according to a new report. 

Through November 8, a total of about 10.1 million Americans have been disenrolled from Medicaid, the health-care program for low-income Americans, according to researchers at the Georgetown Center for Children and Families and KFF, a health policy group. Roughly 18.4 million people have had their Medicaid coverage renewed, it found.

The 2 million children who have lost coverage represent 21 states that break out enrollment changes by age — and it’s likely an undercount because data is still coming in, said Joan Alker, executive director and research professor at Georgetown said Joan Alker, executive director and research professor at Georgetown.

States in April began removing people from Medicaid’s rolls after the expiration of a pandemic provision that had suspended procedures to remove people from the program, such as if they earned too much money to qualify. But experts have warned that many qualified people are at risk of getting booted, including millions of children, because of issues like paperwork snags or if their families relocated during the last few years. 

About 3 in 4 of the children who have lost Medicaid are eligible for the program, Alker told CBS MoneyWatch.

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“Governors who are not paying good attention to this process are dumping a lot of people off Medicaid,” said Alker, describing the enrollment issues as particularly acute in Florida and Texas. “There is no reason in the United States that children should be uninsured.”

The disenrollment of millions of children and their families could prove to be a massive disruption in the social safety net, removing health care coverage for many of the nation’s neediest families, experts said.

While states and advocates prepared for the policy’s unwinding, coverage losses are growing “even among people still eligible,” the Center on Budget and Policy Priorities said Tuesday in an update.

About 42 million children — more than half of all kids in the country — are covered by Medicaid and the Children’s Health Insurance Program (CHIP), according to the American Pediatric Association. “Ensuring children do not inappropriately lose their health care coverage is critical to supporting their health and wellbeing,” the group has said.

The loss of health coverage for low-income children and their families come as more kids fell into poverty in 2022. The poverty rate for children doubled last year as government-funded pandemic aid dried up, including the end of the expanded Child Tax Credit, and as parents’ incomes shrank.