A relatively quiet week in Washington exploded on Thursday after The Washington Post reported that President Donald Trump referred to “shithole countries” in a meeting with lawmakers, suggesting that the U.S. should take in more people from Norway. The comment provoked an immediate backlash at a moment when the administration was trying to sustain its political momentum after getting a major tax-reform law signed. On Capitol Hill, Congress made little progress toward a budget deal, as lawmakers stare down yet another government shutdown deadline next week.

Beneath the firestorm over the president’s language, the Trump administration made a number of real policy moves—including a big one on immigration. Nearly a year into his presidency, Trump continues to rescind Barack Obama’s legacy and enact a new conservative agenda, including one of the most radical Medicaid reforms in the program’s history. Here’s how Trump changed policy this week:

1. Trump ends protections for 200,000 Salvadorans

Almost forgotten after the “shithole” comment was Trump’s big immigration move on Monday, when the Department of Homeland Security revoked a special immigration status for more than 200,000 citizens of El Salvador who have lived and worked in the U.S. since that country was hit by a massive earthquake in 2001. They will be required to leave the U.S. by September 9, 2019. The Salvadorans are just the latest group of immigrants to lose temporary protected status— a program that was designed to be temporary, but has been repeatedly extended under both Democratic and Republican administrations.

Immigration advocates slammed the move, saying the elimination of TPS status for the Salvadorans was unnecessary and inhumane, ripping families apart and hurting the U.S. economy. Supporters said the administration was just following the law and that the status was designed to be temporary, not permanent. The immigrants now have 18 months to decide whether to return to their home country or live undocumented in the U.S., at risk of deportation—unless Congress steps in.

2. A new era for Medicaid

Congressional Republicans don’t appear interested in taking another shot at repealing and replacing Obamacare this year, after they eliminated the individual mandate in tax reform. But the Trump administration continues to chip away at the law in other ways, using its executive powers.

This week, the administration announced perhaps its biggest reform yet when the Centers for Medicare & Medicaid Services issued policy guidance for states seeking to implement work requirements in their Medicaid programs. Under the guidance, states would be allowed to require able-bodied Medicaid beneficiaries to work or participate in a work-related activity, such as job training, for at least 20 hours a week to stay covered. People with severe medical conditions would be exempt. Republicans have long supported adding work requirements to the Medicaid program, arguing that they would help move beneficiaries into work and off the government dole. Democrats have long opposed the idea, noting that most Medicaid beneficiaries already work or have a disability and arguing that the proposal will lead to more hardship with little increase in economic self-sufficiency.

The policy guidance effectively greenlights many Republican-led states, including Arizona, Arkansas, Kansas, Maine and others, to submit proposals to CMS, which is expected to review and approve them quickly. In fact, on Friday, it granted the first approval to Kentucky, which submitted its proposal about a year ago.

3. Commerce sets duties on Canadian paper

Trump has spent much of his presidency complaining about Chinese trade practices, vowing to impose new penalties for Chinese steel dumping and intellectual property theft. So far, though, he’s taken few real actions against Beijing. Instead, he’s focused his trade ire on a surprising target: Canada.

On Tuesday, the Trump administration took another shot at our northern neighbor when the Commerce Department imposed preliminary duties on uncoated groundwood paper, arguing that Canada was unfairly subsidizing producers. U.S. imports of uncoated groundwood paper totaled roughly $1.27 billion in 2016. The preliminary duties are minor in the nation’s broader relationship, but they come at a time of rising tensions.

4. Florida gets an exemption from Interior’s drilling plan

When Interior Secretary Ryan Zinke announced last week a major expansion of offshore drilling, he received a predictable backlash from environmentalists. But the overwhelmingly reaction didn’t just come those quarters; he also drew friendly fire from one of Trump’s closest political allies: Florida Gov. Rick Scott, who said new drilling would threaten the state’s tourism industry.

This week, faced with Scott’s criticism, Zinke quickly backtracked and gave Florida an exemption from the plan, which opens up vast stretches of federal waters to oil and gas drilling. Far from quieting the backlash, the move only raised more questions about why Florida got the exemption, as opposed to other coastal states that criticized the drilling proposal. Critics said the move was orchestrated to help Scott politically—he is expected to run for the Senate in Florida—and other states, including those with Republican governors, demanded similar treatment. The Interior Department said it will meet with other governors to determine whether other exemptions are necessary, explaining that Scott was just the first to register his objections. If it does start dishing out more exemptions, Zinke’s big drilling expansion could become a lot smaller.

5. DOL loosens rules on unpaid interns

In 2010, the Department of Labor implemented a six-part test to determine when companies must pay their interns. The new fact sheet didn’t actually change the underlying law but held that employers should consider an intern an employee—and thus pay them the minimum wage and overtime pay—unless they met all six conditions of the test, including that the internship mirror an educational experience and the internship is not a substitute for a paid employee.

Late last Friday—yes, we know, not quite this week—the Trump administration officially abolished the six-part test and reverted to the “primary beneficiary test,” which allows for unpaid internships as long as the intern benefits more than the employer. Labor advocates slammed the move, saying it will allow employers to take advantage of younger workers. The DOL defended it by noting that four courts have already ruled against the Obama-era six-part test and arguing that the “primary beneficiary test” gives businesses more flexibility. The change, the agency said, would allow more businesses to offer internships and give more Americans the opportunity a chance to develop workplace skills.

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