The Trump administration is preparing to release guidelines soon for requiring Medicaid recipients to work, according to sources familiar with the plans, a major shift in the 50-year-old program.

The guidelines will set the conditions for allowing states to add work requirements to their Medicaid programs for the first time, putting a conservative twist on the health insurance program for the poor.

Democrats are gearing up for a fight, likely including lawsuits, arguing the administration is trying to undermine ObamaCare’s Medicaid expansion on its own after Congress failed to repeal the health law.

The changes represent the vision of Seema Verma, President Trump’s administrator of the Centers for Medicare and Medicaid Services (CMS), who has long worked on conservative Medicaid changes.

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