New rules will affect 'able-bodied, working-age Medicaid beneficiaries' in states that seek Medicaid waivers.

The Trump administration issued new guidance to states Thursday, allowing for a path to compel some individuals to work or prepare for work to receive medical benefits under a joint state-federal program.

Trump to let states force work for health care ile ilgili görsel sonucu

In a letter to state Medicaid directors, the administration said it "will support state efforts to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility."

The new rules will affect "able-bodied, working-age Medicaid beneficiaries" in states that choose to seek waivers in-line with the new guidance.

The major policy shift seeks to overhaul the long-standing social contract between state and federal governments and poor citizens who rely on their services. Medicaid is a fundamental avenue for health care for many of the nation’s poor.

About 20 percent of Americans rely on Medicaid, and the policy shift could have dramatic effects on them. Pregnant women, the elderly, individuals with disabilities or other health issues preventing work and, victims of domestic violence would be exempted from the new guidance, according to the letter from the Centers for Medicare & Medicaid Services (CMS).

Ten states have already said that they will pursue the new work-for-Medicaid waivers, according to the administration. They include Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

The first waiver under the new guidance could come as soon as Friday, the Washington Post reported citing two people with knowledge of the process.

President Donald Trump and his administration have consistently said they are seeking to overhaul Medicaid, which was greatly expanded under President Barack Obama as part of his landmark overhaul of America's health care system.

“Medicaid needs to be more flexible so that states can best address the needs of this population. Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries, and today’s announcement is a step in that direction,” CMS Administrator Seema Verma said in a statement.