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President Donald Trump’s administration has issued new guidance that would allow states to impose work requirements on low-income healthcare recipients.

According to the document, able-bodied recipients of the Medicaid health program for the poor would be required to work, volunteer or prepare for a job through school or training.

However, critics argue that the move is aimed at cutting the number of people receiving government-funded Medicaid.

The administration contends the policy is to promote “community engagement”.

Seema Verma, administrator for the Centers for Medicare and Medicaid Services, said: “This is about helping those individuals rise out of poverty.

“Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries, and today’s announcement is a step in that direction.”

Seema Verma said the new policy came about at the request of 10 different states including Kentucky, Maine, New Hampshire, Arizona, Indiana and Utah.

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The new guidance also suggests considering exemptions or “reasonable modifications” for certain Medicaid recipients, including elderly, pregnant or disabled people; those in areas with high unemployment or people caring for children or elderly relatives; people with substance abuse disorders such as opioid addiction.

It states that a review of studies showed, “strong evidence that unemployment is generally harmful to health, including higher mortality; poorer general health; poorer mental health; and higher medical consultation and hospital admission rates”.

The report also states that people with a full-time job are less likely to suffer from depression.

As of October 2017, nearly 75 million individuals were enrolled in Medicaid and the children’s health insurance program (CHIP).

According to a study by the nonpartisan Kaiser Family Foundation, almost 60% of working-age Medicaid recipients are already employed full time or part time.

It is unclear how many Medicaid recipients who are actively seeking work may lose their insurance in the process if their state should choose to enact the new guidelines.

Several members of Congress were outspoken against the decision.

Under President Barack Obama’s Affordable Care Act, ObamaCare, 31 states expanded Medicaid coverage. Republicans have tried repeatedly to overturn the health law.

The Obama Administration had previously rebuffed proposals allowing states the right to impose work requirements on Medicaid recipients, arguing it would result in fewer people having access to health insurance.

In order to implement any new policy based on the guidance, states would have to propose the changes through waivers and wait until they are granted federal approval.

Republican efforts to find a replacement for ObamaCare have collapsed.

Two Republican senators said they opposed the GOP’s proposed alternative, making it impossible for the bill to pass in its current form.

The GOP has been divided on the issue, with moderates concerned about the effects on the most vulnerable.

President Donald Trump has now called for repeal of President Obama’s healthcare system, so Republicans can start “from a clean slate”.

That task falls to Senate Majority Leader Mitch McConnell.

Mitch McConnell said: “Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of ObamaCare will not be successful.”

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President Trump had made repealing and replacing ObamaCare, under which more than 20 million people gained healthcare coverage, a key campaign pledge.

Republicans view the 2010 legislation as an overreach of the federal government and say patients have less choice and higher premiums.

The GOP’s proposed alternative had kept key ObamaCare taxes on the wealthy, while imposing sharp cuts to healthcare for the poor and allowing insurers to offer less coverage.

Two Republican senators, Mike Lee and Jerry Moran, said the new legislation did not go far enough in repealing ObamaCare.

Jerry Moran said “we should not put our stamp of approval on bad policy” while for Mike Lee, “in addition to not repealing all of the ObamaCare taxes [the bill] doesn’t go far enough in lowering premiums for middle class families; nor does it create enough free space from the most costly ObamaCare regulations”.

Two senators – Rand Paul and Susan Collins – had already opposed the bill.

Rand Paul said the bill kept too much of the “ObamaCare taxes”, while Susan Collins expressed concerns about cuts to Medicaid.

With the two new opponents, Republicans – who hold 52 seats – no longer have enough votes to pass the bill in the 100-member Senate.

Moderate Republicans had also said the bill would have harmed some of their vulnerable constituents.

The non-partisan Congressional Budgetary Office (CBO) found the bill would have stripped 22 million Americans of health insurance over the next decade.

On top of that, polls had shown ObamaCare remained popular among Americans – a survey by the Washington Post and ABC News on July 17 found more than twice as many people preferred Barrack Obama’s program to the proposed alternative.