From January 1, 2027, adults covered through Medicaid expansion must show 80 hours a month of work, school, or community service, or qualify for an exemption, at every renewal. This model counts 18,625,071 adults subject nationally (CBO: 18,500,000) and projects 5,461,400 losing coverage by 2034 (CBO: 5,200,000; Urban Institute for 2028: 4,900,000 to 10,100,000).
Most of that loss is people who qualify but cannot get through the paperwork. Each state page shows who is subject, why eligible people fall off, how well the state can renew people automatically, and the county numbers.
States
| State | Expansion | Adults subject | Projected loss by 2034 | Ex parte score |
|---|---|---|---|---|
| Alabama | No | 0 | 0 | n/a |
| Alaska | Yes | 61,244 | 35,542 | 57 |
| Arizona | Yes | 476,311 | 155,925 | 75 |
| Arkansas | Yes | 218,861 | 99,469 | 69 |
| California | Yes | 4,700,448 | 1,022,390 | 74 |
| Colorado | Yes | 357,249 | 86,786 | 66 |
| Connecticut | Yes | 294,653 | 65,444 | 75 |
| Delaware | Yes | 63,963 | 19,735 | 57 |
| District of Columbia | Yes | 111,319 | 30,319 | 76 |
| Florida | No | 0 | 0 | n/a |
| Georgia | Waiver | 3,916 | 0 | |
| Hawaii | Yes | 122,248 | 29,771 | 68 |
| Idaho | Yes | 83,021 | 33,487 | 59 |
| Illinois | Yes | 761,540 | 211,377 | 72 |
| Indiana | Yes | 484,417 | 229,055 | 62 |
| Iowa | Yes | 167,800 | 74,381 | 56 |
| Kansas | No | 0 | 0 | n/a |
| Kentucky | Yes | 434,069 | 153,075 | 75 |
| Louisiana | Yes | 694,371 | 261,774 | 69 |
| Maine | Yes | 90,446 | 27,119 | 63 |
| Maryland | Yes | 310,140 | 83,399 | 71 |
| Massachusetts | Yes | 321,878 | 72,142 | 72 |
| Michigan | Yes | 670,144 | 216,131 | 65 |
| Minnesota | Yes | 198,564 | 48,600 | 74 |
| Mississippi | No | 0 | 0 | n/a |
| Missouri | Yes | 327,567 | 164,291 | 67 |
| Montana | Yes | 70,456 | 31,982 | 54 |
| Nebraska | Yes | 65,180 | 27,359 | 62 |
| Nevada | Yes | 265,520 | 83,853 | 72 |
| New Hampshire | Yes | 56,968 | 19,288 | 71 |
| New Jersey | Yes | 511,168 | 163,511 | 60 |
| New Mexico | Yes | 231,344 | 85,410 | 62 |
| New York | Yes | 1,861,116 | 406,888 | 62 |
| North Carolina | Yes | 625,855 | 246,441 | 81 |
| North Dakota | Yes | 23,561 | 10,994 | 50 |
| Ohio | Yes | 659,491 | 224,631 | 73 |
| Oklahoma | Yes | 224,019 | 126,302 | 50 |
| Oregon | Yes | 644,844 | 192,348 | 74 |
| Pennsylvania | Yes | 769,099 | 217,271 | 41 |
| Rhode Island | Yes | 71,519 | 19,422 | 77 |
| South Carolina | No | 0 | 0 | n/a |
| South Dakota | Yes | 27,916 | 13,611 | 50 |
| Tennessee | No | 0 | n/a | n/a |
| Texas | No | 0 | 0 | n/a |
| Utah | Yes | 77,239 | 27,676 | 58 |
| Vermont | Yes | 57,298 | 16,488 | 74 |
| Virginia | Yes | 588,844 | 198,960 | 63 |
| Washington | Yes | 559,113 | 138,417 | 81 |
| West Virginia | Yes | 159,195 | 51,586 | 60 |
| Wisconsin | Waiver | 121,155 | 38,753 | |
| Wyoming | No | 0 | 0 | n/a |