Wisconsin Republican state lawmakers have approved a Medicaid work requirement during the legislature's lame-duck session in an effort to block the incoming Democratic governor from abandoning the changes set by his GOP predecessor.

The vote, which occurred early Wednesday morning, makes official a provision that will require certain Medicaid beneficiaries to work, volunteer, or take classes for 80 hours a month. If enrollees fail to follow the requirement for 48 months in a row they will be dropped from coverage.

All Democrats and one Republican, Rep. Todd Novak, voted against it.

The changes have the support of GOP Gov. Scott Walker, who lost re-election this year to Gov.-elect Tony Evers and will be leaving office in five weeks. The Trump administration approved the work requirement plan Oct. 31, but Evers said he planned to stop the policy from going into effect. The legislature's move will allow the work requirements to go forward.

It also codifies other parts of the plan. The new requirement will obligate certain people to pay premiums, of about $8 a month, and also to pay out-of-pocket costs of $8 when they go to the emergency room for care. People enrolled in Medicaid would also undergo a health risk assessment that will include asking about drug use.

The plan will cover residential treatment for substance abuse disorder, and people will be able to reduce their premiums by making healthy lifestyle choices such as wearing a seatbelt, maintaining a healthy weight, and not smoking.

Under Obamacare, states were allowed to expand government-funded Medicaid coverage to people of under specific income level, of roughly $17,000 a year, regardless of whether they are working. Medicaid otherwise covers pregnant women, people with disabilities, people in nursing homes, and children, a group that members of the Trump administration and conservatives say should remain the focus of the program.

Though the work requirements contain multiple exemptions for people undergoing treatment for addiction and for caregivers, among other groups, critics say people will be unable to keep up with the reporting requirements and become uninsured. They have said that tracking the work requirement is more expensive than healthcare coverage.

A work requirement enacted in Arkansas resulted in more than 12,000 people being removed from Medicaid. The state removes enrollees after they have failed to report their hours for three months in a row. The program is facing a legal challenge but is still in effect.