The Center for Budget and Policy Priorities reports that participation has dropped in every state except Alaska. While the national average decline sits at 12%, some regions have seen far more severe impacts; Arizona, for instance, recorded a 45% reduction in enrollees over the past year. Analysts note that while some downward trends preceded the 2025 reconciliation law, the legislation significantly intensified the drop-off.
The fiscal pressure is expected to mount further by 2027. Under the new budget framework, states will become responsible for covering between 5% and 15% of benefit costs based on their current error rates. This shift creates a strong financial incentive for states to aggressively reduce program costs, potentially leading to the improper denial or delay of benefits for eligible residents.



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