At the onset of the COVID-19 pandemic, the federal government implemented a policy to provide additional Medicaid funds to states and restricted the ability of states to disenroll people from Medicaid, requiring continuous enrollment. The number of Granite Staters accessing health coverage through Medicaid increased 40.6 percent during this period, with Medicaid Expansion program enrollment for adults with low incomes rising 87.2 percent. The federal continuous enrollment provision expired on April 1, 2023, and New Hampshire began disenrolling people from Medicaid based on their eligibility using pre-pandemic rules. At the end of September 2023, total Medicaid enrollment had declined by 67,134 people (36.4 percent) relative to the end of March 2023, with a 38,276 (39.6 percent) decline in the Medicaid Expansion population. Total enrollment remained 5,427 (3.0 percent) higher than it was immediately before the pandemic reached New Hampshire, without adjusting for population growth.