On March 14, Health and Human Services (HHS) Secretary Thomas Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma sent a letter to Governors expressing the Administration’s priorities in Medicaid policy. Among the topics mentioned were speeding up the review of state plan amendments and waivers, allowing more premiums or contributions from beneficiaries, the use of alternative benefit plan designs such as health savings accounts, and waivers of retroactive coverage and presumptive eligibility. The letter also referred to the Administration’s openness to using demonstration authority to develop health care plans that focus on training and employment. This has been widely interpreted to indicate that the Administration will consider work requirements for adults applying for Medicaid, a proposal that a number of states had included in demonstrations but the previous Administration would not approve. The letter also indicated the Administration would be pursuing additional time for states to implement the Home and Community-Based Services settings rule and looking at ways to engage with states on the implementation of the rule. The Arc has expressed concern about the letter.