The Trump administration early Thursday initiated a pivotalchange in the Medicaid program, announcing that for the first timethe federal government will allow states to test work requirements as a condition forcoverage.

The announcement came in a 10-page memo with detailed directions about how states canreshape the federal-state health program for low-income people.

The document details who should be excluded from the new workrequirements — including children and people being treated foropioid abuse — and offers suggestions as towhat counts as “work.” Besides employment, it can include jobtraining, volunteering or caring for a close relative.

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