Medicaid recipients are the latest vulnerable group of Americans Trump targets while he hands out billions to the idle rich.

The Trump administration believes the most overburdened working families in America do not have enough stress in their lives, and it’s working with Republican governors to strip them of vital health care services.

The White House sent a letter to the directors of state Medicaid agencies that gives them the green light to cut off Medicaid benefits, a reversal from the Obama administration. Now those states, largely led by Republican governors, will be able to throw vulnerable Americans out into the cold, while their families — who are already working to support them with multiple jobs — will face an even larger burden.

The new initiative gives conservative states the power to impose work requirements on Medicaid recipients, an echo of the policies enacted decades ago on families receiving welfare. At that point, instead of simply helping fellow Americans through rough, devastating moments in their lives, the government imposed draconian restrictions in exchange for food aid and cash assistance. It was the fulfillment of long-term conservative dreams of leaving the poor out to dry while enacting tax cuts for the extremely wealthy.

In an Orwellian turn of phrase, the Trump administration said the harsh new policies are “innovations” that “build on human dignity.”

Families who are already working more than one job, attempting to support their relatives who are dependent on Medicaid right now, will not be dignified by these so-called “innovations.”

Washington Democrat Patty Murray — ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee — blasted the new proposed restrictions.

“It speaks volumes that after spending a year sabotaging families’ health care and jamming through tax cuts for massive corporations and the wealthiest, one of President Trump’s first priorities in the new year is to pull the rug out from people who simply want affordable health care they can rely on,” Murray said in a statement. “Patients and families have spoken out time and time again to reject President Trump and Republicans’ attempts to take their health care away by undermining Medicaid—so I hope my Republican colleagues will join me in loudly rejecting this President’s latest harmful step.”

Leonardo Cuello, health policy director at the National Health Law Program, told the Washington Post that the policy is “not a good idea, and it’s illegal.” He also slammed the letter’s argument that work will promote healthiness.

“It’s a little like saying that rain causes clouds,” he said. “It’s more that people [with Medicaid] get care, which helps them be healthy and makes them able to work.”

Now, that path to care and health is being eliminated. States will not even be allowed to use Medicaid funds to help the people being hurt to find child care, transportation, or job training. They will just be cut off from the vital federal program.

And in fact, 60 percent of the non-elderly people on Medicaid are already working, a statistic that runs counter to the Trump administration’s characterization of them. And of those who aren’t working, over 30 percent of them are ill or disabled, 30 percent are caring for young children, and 15 percent are enrolled in school.

The policy change comes at the same time the administration’s tax legislation, tilted in favor of the extremely wealthy getting government handouts, begins to take hold. On one hand, Trump continues to punish the vulnerable who are in a predicament through no fault of their own, while rewarding the idle rich for simply accumulating billions in wealth, often without having truly worked a single second of their lives.

Cruelty is the Trump doctrine and approach. In this instance, it is Medicaid recipients and their families. In other instances, it is giving nursing homes leniency even if they abuse elderly patients, or pushing children to handle brain-damaging chemicals, and allowing fracking companies to hide toxic chemicals on public land.

It is a full-throated endorsement of cruelty, and Trump and his Republican Party are completely on board.