The Trump administration initiated a pivotal change in the Medicaid program, announcing that the federal government will allow states to test work requirements as a condition for coverage.

Despite spending approved by Congress in late December that was expected to keep the program running for three months, some states will start running out of money much sooner.

U.S. health spending rose to $3.3 trillion in 2016, but the pace slowed compared to the previous two years as demand for drugs, hospital care and physician services weakened.

While the Affordable Care Acts fifth open enrollment season is off to a surprisingly good start, many uninsured people said they werent even aware of it, according to a survey released Friday.

The Trump administrations recent endorsement of work requirements in Medicaid and increased state flexibility is part of broader strategy to shrink the fast-growing program for the poor and advance conservative ideas that Republicans failed to get through Congress.

The Trump administration signaled Tuesday that it would allow states to impose work requirements on some adult Medicaid enrollees, a long-sought goal for conservatives.

Nearly 90 percent of the Indiana's 554 nursing homes have been leased or sold to county hospitals, state records show, bringing in hundreds of millions in extra federal payments to the state.

While congressional Republicans and President Donald Trump have been seeking major cuts in federal funding of Medicaid, 26 states this year expanded or enhanced benefits and at least 17 plan to do so next year.