The Trump administration on Friday approved Ohio’s request to impose work requirements on Medicaid beneficiaries, a sign that recent legal challenges have not slowed efforts to implement the controversial rules.

Starting in 2021, Medicaid beneficiaries ages 19 through 49 in Ohio will need to work, attend school, volunteer or attend job training for at least 80 hours a month to remain in the health care program. Beneficiaries who do not meet the requirements for 60 days will lose their coverage.

Unlike other states, people who lose coverage in Ohio will be allowed to immediately reapply for enrollment.

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The Trump administration has made it a priority to approve conservative Medicaid waivers for states that apply for them. Ohio is the ninth state to be granted approval since President Trump Donald John TrumpOmar fires back at Trump over rally remarks: 'This is my country' Pelosi: Trump hurrying to fill SCOTUS seat so he can repeal ObamaCare Trump mocks Biden appearance, mask use ahead of first debate MORE took office, but only Arkansas has implemented their requirements.

The administration has encouraged other states to apply for similar waivers.

By the end of last year, more than 18,000 people had lost coverage in Arkansas for failing to meet the requirement. They were eligible to reapply in January.

In Ohio, the state estimated that just over 18,000 people — about half the people who will be subject to the work requirements— will lose coverage. The requirements won't apply to adults who are disabled, pregnant women, children, caretakers or people living in parts of the state with high unemployment.

Ohio Gov. Mike DeWine (R) said in a statement that the requirements “are intended to put those able-bodied adults served by the Medicaid expansion on a pathway to full employment.”

Centers for Medicare and Medicaid Services Administrator Seema Verma tweeted she was “pleased to send @GovMikeDeWine the 9th approval of a community engagement waiver!”

#Ohio added over 20k jobs in January. With unemployment steady under 5%, there are great opportunities to connect adults on #Medicaid w/ opportunities to improve their lives & health – so I’m pleased to send @GovMikeDeWine the 9th approval of a community engagement waiver! pic.twitter.com/66mahDqZqn — Administrator Seema Verma (@SeemaCMS) March 15, 2019

Under ObamaCare, states are given the option to expand Medicaid to childless low-income adults who didn’t previously qualify for the program.

The Trump administration argues that “able-bodied” adults should instead be working, and that Medicaid should be reserved for children, women who are pregnant, adults who are disabled and residents with very low incomes.

Opponents of work requirements say the new rules don’t improve public health and are instead designed to save states money by kicking people off Medicaid.

The approval comes just a day after the Trump administration was in federal court defending the work requirements for Arkansas and Kentucky. The judge, who is overseeing both cases, said he will decide by April 1 whether to block further implementation in Arkansas and if the rules should be struck down in Kentucky.