One year ago this week, the One Big Beautiful Bill Act became law. The first-year data are now in. They are not ambiguous.

SNAP participation fell by more than four million people — a 10 percent national drop — between the OBBBA's enactment in July 2025 and March 2026. [1] Participation rates declined in every state in the nation. Forty-two states recorded drops of 5 percent or more; 21 states recorded drops of 10 percent or more. In Arizona, SNAP participation fell 53 percent. In Florida, 17 percent. In Louisiana and Oklahoma, 16 percent each. [1] More than 700,000 children lost SNAP benefits in the 12 states where child participation data were tracked through April 2026. [1]

The ACA marketplace numbers tell a parallel story. Premiums on marketplace plans rose 58 percent in the first year; average deductibles rose 37 percent. [1] The insurance still exists. It is no longer affordable for a large share of the people who held it.

The Medicaid numbers are not yet in. They cannot be. The OBBBA's Medicaid work requirements — the provision that will affect the largest number of people — do not take full effect until December 2026. A RAND Corporation analysis published this year projects that the Medicaid provisions in the OBBBA will reduce states' Medicaid budgets by $679 billion and produce 7.6 million coverage losses nationally, measured against a 2034 baseline. [2] Those 7.6 million people are not yet counted. The first-year receipt, substantial as it is, does not include them.

The sequencing is the story

The OBBBA was constructed on a deliberate timeline. Tax cuts flow immediately: they are visible in corporate earnings, in the tax returns that arrived this spring, in the market performance that the law's supporters cite. Spending reductions — Medicaid work requirements, SNAP eligibility restrictions, ACA marketplace subsidy changes — were scheduled to take effect across 2026, 2027, and 2028. [1]

This sequencing was not an accident. It was a legislative choice. The practical consequence is that 2026 is the year in which the tax benefits of the OBBBA are fully visible while the Medicaid costs are not yet measurable. The anniversary coverage will show, on one side of the ledger, corporate tax relief, extended individual tax rates, and a GDP growth number. On the other side: 4 million off SNAP, more than a million off ACA marketplace plans, and a Medicaid cliff arriving in December. The two sides of that ledger will not be legible at the same time until at least 2027. [1]

CBS News covered the anniversary through a winners-and-losers frame, which is formally accurate. [3] Corporations won; low-income households lost. The frame does not convey the scale differential. The tax relief flows to the wealthiest quintile of income earners. The benefit reductions fall on SNAP participants, ACA marketplace enrollees, and Medicaid recipients — populations defined by income floors, not ceilings.

Arizona is the legible case

The 53-percent SNAP reduction in Arizona makes the national 10-percent figure legible as a human process, not a statistical artifact. [1] That drop did not happen because 53 percent of Arizona SNAP participants found employment or crossed an income threshold. It happened because the OBBBA's eligibility restrictions — expanded work requirements, documentation rules, re-verification timelines — were implemented by state agencies with different administrative capacities and different political incentives. Arizona moved fast and dropped many. Other states moved more cautiously and dropped fewer. The national average is the sum of those administrative choices.

The children's number deserves its own accounting. More than 700,000 children — who cannot satisfy work requirements, who do not control household income, who have no recourse against an eligibility determination — lost SNAP access in the 12 states with available data. [1] The total for all 50 states is not yet published. The partial count is already large.

What December means

The RAND projection of 7.6 million Medicaid coverage losses is not a worst-case estimate; it is a 2034 midpoint calculated from the OBBBA's documented Medicaid work requirements, eligibility restrictions, and state-level behavioral responses. [2] The projection runs across a decade because Medicaid coverage loss is not a sudden event; it is a gradual administrative process of failed re-enrollments, lapsed documentation, and missed work-requirement reporting.

December 2026 is when the OBBBA's Medicaid work requirements begin reaching the households most exposed. The first-year data set — SNAP down 4 million, ACA marketplace premiums up 58 percent — will look like the prelude when the Medicaid numbers arrive in 2027 and 2028.

The paper's obligation, at the one-year mark, is to read the actual receipt rather than the projected one. The actual receipt says: 4 million fewer people receiving food assistance, 700,000 fewer children, premiums that rose 58 percent on plans that remain legally available. The December receipt is coming. This is what arrived first.

-- NORA WHITFIELD, Chicago