The Donald Trump administration approved New Hampshire’s waiver, becoming the fourth state to implement work requirements for Medicaid.

New Hampshire Republican Gov. Chris Sununu said in a statement on Monday:

Work requirements help lift able-bodied individuals out of poverty by empowering them with the dignity of work and self-reliability while also allowing states to control the costs of their Medicaid programs. They help people gain the skills necessary for long-term independence and success.

Sununu added, “Today’s announcement by CMS authorizing New Hampshire’s Medicaid work requirements is a transformative step towards a more thriving workforce.”

New Hampshire became the fourth state to implement work requirements – behind Arkansas, Indiana, and Kentucky. Under New Hampshire’s waiver, able-bodied adults without dependents aged 19 to 64 will have to complete 100 hours a month of employment, education, job skill training, or community service to obtain Medicaid.

The waiver also requires that Medicaid recipients who make more than 100% of the poverty level submit co-pays for medical treatment.

Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma cheered the approval of New Hampshire’s waiver in a statement on Monday, saying, “Honored to sign New Hampshire’s Medicaid community engagement program today. I congratulate Gov. Chris Sununu’s commitment to join me in improving the lives of Medicaid beneficiaries by creating a crucial link to work and community engagement.”

Honored to sign New Hampshire’s #Medicaid community engagement program today. I congratulate @GovChrisSununu’s commitment to join me in improving the lives of Medicaid beneficiaries by creating a crucial link to work and community engagement. pic.twitter.com/wTZrT3eHyz — Administrator Seema Verma (@SeemaCMS) May 7, 2018

A Rassmussen poll in January found that 64 percent of Americans approve of work requirements for Medicaid.

Wisconsin Gov. Scott Walker, another state leader seeking work requirements for Medicaid, said that social safety net programs should lift people up rather than trapping them in a cycle of poverty.

“We should treat public assistance more like a trampoline than a hammock,” Walker explained last May.

President Donald Trump pledged during the presidential campaign to “get our people off of welfare, back to work.”