The LePage administration has sent a letter outlining changes to Maine’s Medicaid program that they want green-lit by President Donald Trump.

The impact of all of these proposed changes is unclear, but they include premiums and other changes that the Maine Department of Health and Human Services said in a news release will be sent to the Trump administration as part of a waiver request “in the coming days.”

It’s part of a longstanding effort by the LePage administration to scale back MaineCare, Maine’s version of Medicaid, the federal health care program for the poor. It touted culling 67,000 from the program between 2011 and 2015 and has proposed a change this year that would cut another 18,000 from the program.

Trump’s victory in 2016 led to speculation that Maine would be able to enact other welfare policies that President Barack Obama’s administration stymied, including a ban on buying junk food with food stamp money.

But the list of policies outlined in the letter from DHHS Commissioner Mary Mayhew to Rep. Tom Price, R-Georgia, who is Trump’s nominee for health and human services secretary, goes farther than that to include:

• Premiums and coinsurance: Mayhew said the state will request authority to charge $20 in a monthly coinsurance payment for all members, plus “reasonable monthly premiums” for adults in the program. Those payments would be limited to “populations who have the ability to earn income” and tailored to their ability to pay, but people who don’t pay required premiums would face temporary removal from the program. It’s intended to “engage individuals in taking responsibility for their own health.” Many states have some sort of premium in their Medicaid programs, according to the Kaiser Family Foundation.

• An asset test: LePage has sought a $5,000 asset limit with certain exceptions for the food stamp program and Mayhew said they want one in Medicaid, too, but details aren’t fleshed out in the letter.

• Not covering prior care: Mayhew says the state also wants to waive coverage of services incurred during the 90 days before Medicaid eligibility.

This story will be updated.