Michigan Gov. Rick Snyder (R) on Friday signed a bill to impose controversial work requirements on Medicaid recipients.

If the plan is approved by the Trump administration, Michigan would become the fifth state to add work mandates to its program.

In January, Trump officials released their guidelines for work requirements on Medicaid, a move that has drawn a sharp outcry from Democrats, who say the change will lead to people losing health coverage.

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Michigan expanded Medicaid through ObamaCare under Snyder, but he is now proposing to add work requirements for those enrolled under expansion, about 670,000 people.



There are exemptions including for people who are disabled, pregnant, children or elderly. Those who do meet the requirements will have to work for 80 hours per month, or be in school, job training or substance abuse treatment.

Michigan’s plan had drawn national attention for a provision that would have exempted people in counties with high unemployment rates from the work requirements. Critics argued the effect of that would have been to exempt many white people in rural areas while imposing work requirements on minorities in urban areas.



That provision was stripped out of the bill along the way and is not in the final version.

Still, patient groups, including the American Heart Association and American Cancer Society Cancer Action Network opposed the bill, arguing it could cause people to lose coverage.

Those groups said the bill would “take health care coverage away from low-income families and individuals who cannot prove they work 80 hours a month or more.”

“Family members who are providing care to loved ones, people who are between jobs and those who are too sick to work could lose access to lifesaving treatment,” they added.