The Trump administration will allow states to ​require able-bodied adults ​work ​to receive Medicaid, a major policy change that could affect millions of low-income Americans.

The federal Center for Medicare &Medicaid Services​ ​on Thursday​ ​released guidance to states that want Medicaid recipients​ ​to work, volunteer or take part in job training.

CMS administrator Seema Verma said the changes were made at the request of states seeking to make the 50-year-old ​health ​insurance program more responsive and “help people in achieving greater well-being and self-sufficiency.”

“Medicaid needs to be more flexible so that states can best address the needs of this population,” she said in a statement. “Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries.”

Ten states – Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin – have already sought waivers.

The elderly, disabled, children and pregnant women would be excluded from the requirements.

Medicaid, the government’s largest health insurance program, covers more than 70 million people.

Former President Obama, under the Affordable Care Act, allowed states to expand the program to include low-income adults who have jobs that don’t provide health insurance. ​The administration opposed work mandates for coverage.​

Democrats oppose the changes, arguing that they are just another step in Republican efforts to ​dismantle the safety net.

“Today’s attack on Medicaid is just the latest salvo of the Trump Administration’s 2018 war on health care,” Brad Woodhouse, director of the pro-ObamaCare group Protect Our Care, said in a statement. “Having faced overwhelming public rejection of their failed attempts to repeal health care, Trump and his Congressional Republicans are now going for death by a thousand cuts.”

According to the Kaiser Family Foundation, 36 percent of Medicaid ​beneficiaries​ said they weren’t working because of illness or a disability​, 30 percent said they​ stayed home to care for a family member and 15 percent were attending school.

​Six percent were looking for work.​

With Post wires