(WASHINGTON) — A federal judge is blocking Medicaid work requirements in two states, dealing a blow to the Trump administration’s efforts to push the poor toward self-sufficiency.

U.S. District Judge James E. Boasberg issued two decisions Wednesday finding that Medicaid work requirements for low-income people in Arkansas and Kentucky pose numerous obstacles to getting health care that haven’t been adequately addressed by federal and state officials.

He sent the federal Health and Human Services Department back to the drawing board.

Work requirements are already in effect in Arkansas, but Kentucky’s program has been on hold because of lawsuits.

Advocates for the poor say Medicaid is a health care program, and work requirements have no place.

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