The Trump administration said Thursday that it will allow states to begin requiring people who receive medicaid to work for the privilege.

According to the Associated Press, states may now require “able-bodied” recipients of Medicaid to contribute to the community in some way before they can receive their benefits. It should be noted that this change in rules is not a federally mandated one, but allows states to utilize the option should it choose to, or need to.

Exemptitions from these rules are:

—Pregnant women, disabled people and the elderly.

—Taking into account hardships for people in areas with high unemployment, or for people caring for children or elderly relatives.

—Allowing people under treatment for substance abuse to have their care counted as “community engagement” for purposes of meeting a requirement.

According to AP, the decision has had both positive and negative reactions. One of those who advocate for the move is the head of the Centers for Medicare and Medicaid Services itself:

Seema Verma, head of the Centers for Medicare and Medicaid Services, said requiring work or community involvement can make a positive difference in people’s lives and in their health. The goal is to help people move from public assistance into jobs that provide health insurance. “We see people moving off of Medicaid as a good outcome,” she said.

Kentucky Sen. Damon Thayer agrees:

In Kentucky, which expanded Medicaid, Republican state Sen. Damon Thayer said work requirements could lessen the program’s impact on the state budget. They also hearken back to the program’s original intent, he added, “as temporary assistance to try to help people get back on their feet, not a permanent subsidy for someone’s lifestyle, if they’re capable of working.”

But Democrats see the requirement as a potential hurdle that could see help denied to people who need it, like Oregon Sen. Ron Wyden who is the top Dem on the committee that oversees Medicaid. Wyden said “Health care is a right that shouldn’t be contingent on the ideological agendas of politicians.”

According to the Associated Press, Democrats may be out of touch with the public’s view of how Medicaid should be doled out, however:

A poll last year from the nonpartisan Kaiser Family Foundation found that 70 percent of the public supported allowing states to require Medicaid recipients to work, even as most Americans opposed deep Medicaid cuts sought by congressional Republicans and the Trump administration.

According to the administration, ten states have already applied for the wavers. This includes Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. Kentucky’s is reportedly going to be approved very shortly.