Indiana on Friday became the second state to win federalapproval to add a work requirement for adult Medicaid recipientswho gained coverage under the Affordable Care Act, but a less debated“lockout” provision in its new plan could lead to tens of thousands ofenrollees losing coverage.

The federal approval was announced by Health and Human ServicesSecretary Alex Azar in Indianapolis.

Medicaid participants who fail to submit in a timely mannertheir paperwork showing they still qualify for the program will beblocked from enrollment for three months, according to the updatedrules.

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