Some low-income people who rely on Medicaid may have to meet new work requirements to keep their healthcare under legislation passed by the Florida House on Wednesday.

Medicaid recipients who are able to work would have to prove to the state that they are working, actively seeking work or enrolled in a job-training program. It wouldn’t apply to people with disabilities, the elderly and children, groups that make up the majority of Florida’s Medicaid enrollment.

Failure to meet the requirement will result in a loss of coverage for a year.

The provision, which was tucked into a broader Medicaid bill (HB 7117), passed 81-34.

Rep. Travis Cummings, R-Orange Park, the Health and Human Services chairman, said it was a “responsible” policy that would help encourage people to get back into the workforce.

But opponents say kicking people off Medicaid will end up costing the state and federal government money. They say that instead of seeking preventive care, sick people will go to hospital emergency rooms, where taxpayers and those with private insurance foot the bills of the uninsured.

“It’s fiscally irresponsible and counterproductive to have a policy where we’re going to promote negative healthcare outcomes because we’re not going to allow these people to have coverage,” said Rep. Lori Berman, D-Lantana.

It’s not clear how many of the 3.2 million people in the state’s primary Medicaid program would have to meet work requirements, and an analysis published by House staff acknowledges that “an indeterminate number of enrollees may be dis-enrolled,” leading to an increase in hospital charity care.

Medicaid in Florida already is restricted to adults with dependent children, pregnant women, low-income seniors and people with disabilities.

For adults to be eligible, they must make less than $6,652 in annual income for a family of three, according to the Kaiser Family Foundation.

Before Florida could institute work requirements for Medicaid, the Senate would have to approve the policy and the federal government would have to agree.

The federal government has allowed work requirements in some states that expanded Medicaid under Obamacare. But, according to the Kaiser Foundation, it has not approved requests by four states to put the requirements into effect for the poorest recipients already eligible for Medicaid, as Florida is trying to do.

However, the Trump administration has shown signs of being open to the idea.

Last month, U.S. Secretary of Health and Human Services Tom Price sent a letter to governors urging them to pursue “innovations that build on the human dignity that comes with training, employment and independence.”

Already, work requirements apply to other government-funded programs for the poor, including food stamps and cash assistance.

Cummings tucked the work requirement into a largely non-controversial set of technical changes to Florida’s Medicaid program requested by the Agency for Health Care Administration.

But AHCA did not request the work requirement or $10 to $15 monthly premiums that the House removed from the legislation Tuesday, spokeswoman Mallory McManus said.

Similar Senate legislation does not include either requirement.