WASHINGTON — Massachusetts, which led the nation in expanding health insurance coverage, now wants to rein in the growth of prescription drug spending for low-income people on Medicaid, but its proposals have met an icy reaction from patients and drug companies.

The state has asked the Trump administration for permission to limit the number of drugs that will be covered in its Medicaid program, seeking to exclude “drugs with limited or inadequate evidence of clinical efficacy.”

The proposal has nationwide implications because many states are struggling with the costs of health care, including prescription drugs. Massachusetts officials say the decision on their request for a Medicaid waiver, which could set a national precedent if it is approved, will show just how serious President Trump is about his vow to bring down drug prices.

Consumer advocates and drug companies have mobilized a campaign to block the proposal, telling the administration that it would deprive Medicaid beneficiaries of access to innovative, lifesaving treatments.