In this file photo, Seema Verma, the head of the Centers for Medicare and Medicaid Services, signs paperwork at the state Capitol in Little Rock, Ark., on Monday, March 5, 2018, that gives the state permission to require that thousands of people on its Medicaid expansion seek ways to work or volunteer. In March 2018, Ms. Verma rejected the state of Idaho's proposals for a workaround of Obamacare regulations. (AP Photo/Kelly P. Kissel)
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