The projections from the health consulting firm Avalere come as states undertake a sweeping reevaluation of the 94 million people enrolled in Medicaid, government’s health insurance for the neediest Americans. A host of problems have surfaced across the country, including hourslong phone wait times in Florida, confusing government forms in Arkansas, and children wrongly dropped from coverage in Texas.

“Those people were destined to fail,” said Trevor Hawkins, an attorney for Legal Aid of Arkansas.

Hawkins helped hundreds of people navigate their Medicaid eligibility in Arkansas, as state officials worked to “swiftly disenroll” about 420,000 people in six months’ time. He raised problems with Arkansas’ process — like forms that wrongly told people they needed to reapply for Medicaid, instead of simply renew it — with the Centers for Medicare and Medicaid Services.