A top Trump administration official says Medicaid work requirements are a form of “true compassion” that aim to help poor people overcome poverty.

“True compassion is lifting Americans most in need out of difficult circumstances,” Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said in a Washington Post column.

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“This administration stands for a policy that makes Medicaid a path out of poverty by empowering states to tailor programs that meet the unique needs of their citizens,” Verma wrote.

On Friday, Indiana became just the second state in the 53-year history of the Medicaid program to gain federal approval to institute work requirements on Medicaid beneficiaries.

The Trump administration approved Kentucky’s request in January, and 11 other states are awaiting approval of similar requests to change their Medicaid programs. The administration released guidance last month that encouraged states to institute work requirements and detailed the types of policies the administration would be likely to approve.

“We applaud their efforts to strengthen the Medicaid program and are supportive of testing approaches to end poverty and improve outcomes,” Verma said in her column.

Some states previously asked the Obama administration for permission to institute work requirements but were denied. CMS officials in the Obama administration said they were flexible in letting states experiment with different Medicaid changes but drew the line at work requirements.

Democrats and health advocates believe work requirements are a deliberate barrier to care. They argue that many Medicaid beneficiaries are already working, and forcing them to jump through bureaucratic hoops just to get health coverage is not compassion.

States that expanded Medicaid under ObamaCare experienced significant decreases in the numbers of uninsured people, and advocates say work requirements are a way for the Trump administration to roll back those coverage gains.

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Trump official: Medicaid work requirements a form of ‘true compassion’