Kentucky is now the first state to require some of its Medicaid recipients to work to get coverage.

A new state program requires adults between 19 and 64 to complete 80 hours per month of “community engagement” which can include getting a job, doing community service, going to school or taking a job training course.

Exemptions to the rule include those who are “medically frail” or suffering from chronic alcohol or drug addiction, pregnant women, full-time students, foster care youth, primary care youth, primary caregivers of dependents, people diagnosed with acute medical conditions would prevent them from complying with the requirements.

Governor Matt Bevin estimates the new program, dubbed Kentucky Helping to Engage and Achieve Long Term Health of Kentucky HEALTH, will save the state $300 million. He also estimates 95,000 could lose their Medicaid benefits because they don’t comply.

The new program is expected to start in July.