COLUMBUS, Ohio (AP) — A federal agency has approved work rules for Ohioans who receive health care benefits through the state’s Medicaid expansion program.

The state Department of Medicaid says Friday’s approval means “able-bodied” Ohioans will need to show they work 20 hours a week or are looking for a job, receiving education or training, or engaged in community service.

The federal Centers for Medicare and Medicaid Services says Ohio is the ninth state to invoke Medicaid work requirements.

Those exempt from the requirement include those 50 or older, parental caretakers, people with chronic conditions, and those who qualify for the Supplemental Nutrition Assistance Program and the Able-Bodied Adults without Dependents program.

Ohio House Democrats say the new rules will cost around 36,000 Ohioans enrolled through Medicaid expansion their health care benefits.