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In a move critics denounced as a “truly savage” effort to “stigmatize the poor” and undermine a life-saving component of the social safety net, the Trump administration on Thursday issued guidance that would for the first time allow states to force work or performance requirements on Medicaid recipients.

“There is perhaps no better example of the moral rot at the core of the Republican Party than imposing so-called ‘work requirements’ on sick Medicaid recipients just weeks after passing a massive tax cut for rich heirs who literally did no work at all to inherit their wealth.”
—Michael Lindon, Roosevelt Institute

While Seema Verma, head of the Centers for Medicare and Medicaid Services, euphemistically described the new guidance as an effort to “transform Medicaid,” analysts argued that the policy shift is little more than a “sneak attack” on an extremely popular program that provides crucial medical coverage to over 70 million Americans.

“This is just the latest in Trump and Republicans’ relentless assault on Medicaid and the broader set of federal programs people rely on. And it’s a sign that there is likely more to come,” observed Chad Bolt, senior policy manager at Indivisible.

As Common Dreams has reported, President Donald Trump and the Republican Party have been eyeing cuts to the already diminished safety net for months, and progressives have repeatedly warned that the deficit-exploding GOP tax plan—signed into law just after Christmas—would serve as a vehicle for draconian changes to Medicare, Medicaid, and Social Security.

Even before the Trump administration’s guidance was issued on Thursday, ten states—including Maine, Arkansas, Indiana, Kansas, and Kentucky—had already requested a federal “waiver” to impose work requirements on Medicaid recipients, and more are likely to follow suit in the coming weeks.

“To qualify for a waiver, a state must provide a convincing justification that its experiment would ‘further the objectives’ of Medicaid,” notes the Washington Post‘s Amy Goldstein.

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Health policy experts were quick to argue that Trump’s new policy will do precisely the opposite.