Kentucky has become the first state to require many of its Medicaid recipients to work to receive coverage, part of an unprecedented change to the nation’s largest health insurance program under the Trump administration.

The Centers for Medicare and Medicaid Services announced the approval Friday. The change will require adults between ages 19 and 64 to complete 80 hours a month of “community engagement” to keep their coverage. That includes getting a job, going to school, taking a job training course or community service.

It’s a big change for Kentucky, which just four years ago embraced former President Barack Obama’s health care law under a previous Democratic governor who won praise for posting some of the largest insurance coverage gains in the country.

Gov. Matt Bevin, a Republican, says more Kentuckians have insurance, but it’s not making them healthier. Kentucky, along with the rest of Appalachia, falls behind the …
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