Wisconsin on Wednesday became the latest state to get approval from the Trump administration to impose work requirements on Medicaid beneficiaries.

The approval of the state’s Medicaid waiver comes as Wisconsin’s Republican governor, Scott Walker, is facing a tight race for reelection against Democrat Tony Evers, who does not support work requirements.

ADVERTISEMENT

If elected, Evers could withdraw or change the waiver. Wisconsin did not expand Medicaid, and the approval marks the first time a nonexpansion state has been given permission to impose work requirements.

Evers has said he supports expanding Medicaid in the state.

The waiver approval comes as the Trump administration faces a lawsuit in Arkansas over similar requirements and despite assessments from the state that thousands of people could lose Medicaid coverage.

A federal judge already struck down work requirements in Kentucky and sent them back to the administration for review.

Under the new rules, Medicaid recipients in the state will be required to work at least 80 hours a month to maintain eligibility. If they fail to do so for 48 aggregate months — any amount of time not working that adds up to four years — they will lose coverage for six months.

The state was also granted permission to charge premiums on beneficiaries and to lock people out of coverage if they fail to pay.

Wisconsin can now charge monthly premiums of up to $8, along with $8 co-payments for emergency room visits for problems that aren't considered emergencies. “Healthy behaviors” can reduce premiums.

In a statement, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma sounded a defiant tone, saying the administration will continue letting states impose work requirements.

“We will not retreat from this position,” Verma said. “Community engagement requirements in Medicaid are not a blunt instrument. This is a thoughtful and reasonable policy, and one that is rooted in compassion.”

Critics of work requirements say they are a way to punish poor people. Critics argue the requirements are only meant to kick people off Medicaid and save the state money.

The administration has repeatedly said work requirements are a way to bring people out of poverty, and Verma defended that position.

“Some believe that our sole purpose is to finance public benefits, even if that means lost opportunity and a life tethered to government dependence,” Verma said in a statement. “Instead, what’s needed are local solutions crafted by policy makers who are closer to the people they serve and the unique challenges their communities face.”

Walker did not get approval to drug test Medicaid beneficiaries, which was one of the most controversial aspects of the waiver request. Wisconsin is in the midst of a major opioid epidemic, and Walker sought to make drug screening mandatory for eligibility.

In a statement, Walker said the requirements will encourage more people to work.

“With more people working in Wisconsin than ever before, we can’t afford to have anyone on the sidelines: we need everyone in the game,” Walker said. “We want to remove barriers to work and make it easier to get a job, while making sure public assistance is available for those who truly need it. Wisconsin is leading the way on welfare reform, and we thank CMS Administrator Seema Verma for her support.”