Republican Gov. Scott Walker of Wisconsin released a proposal Monday that calls for the state to alter its Medicaid program to include a work requirement and to mandate drug testing for beneficiaries who appear to have substance abuse problems.

Under the proposal, the state's Medicaid program, called BadgerCare, would require beneficiaries to be assessed for substance abuse and undergo a drug test "if indicated." People would not become ineligible for Medicaid if they tested positive for drugs, but would be referred to a treatment program or otherwise have benefits delayed for six months. Anyone who refuses testing or assessment would not be eligible to receive Medicaid.

The Department of Health Services indicated in its summary that it was making some of the changes to help combat a statewide drug abuse epidemic, and it also plans to increase revenue to pay for residential addiction treatment by charging some enrollees premiums of between $1 and $10 a month, depending on income.

Under the proposal, which will go to the Trump administration for approval, people could see their premiums halved if they engage in healthy behavior, and beneficiaries would pay co-pays of $8 if they go to the emergency room. For every visit to the emergency room in the 12 months after the first visit, they would pay $25 in copays. That provision was added to "promote appropriate use of healthcare services and behavior that is mindful of healthcare value," according to the summary.

The work requirement proposal would apply to non-disabled adults who are not students and are not over the age of 49. Under the plan, someone who is in Medicaid for four years but doed not participate in a training program or is not employed for at least 80 hours a month would lose eligibility for six months.

Health officials in Wisconsin are releasing a detailed proposal Wednesday and plan to submit a finalized version to the Trump administration by May 26, though they will hold public hearings beforehand.

Walker recently has also proposed drug testing able-bodied adults who are on food assistance and people who receive unemployment benefits.

Medicaid was written under Obamacare to be expanded to low-income people in all states, but because a 2012 Supreme Court decision made expansion optional for states, Wisconsin and 18 other states haven't expanded, for political reasons and over concerns about long-term costs.