President Donald Trump signed an executive order on Monday aimed at improving the U.S. healthcare system by expanding access to pre-existing conditions, allowing consumers to buy insurance across state lines, and allowing insurance companies to sell insurance across states.

But Trump also signaled a shift in how the federal government will respond to states in the coming months, telling reporters on Air Force One on Monday that he will be more willing to take on the states if they are willing to work with him on an expansion of Medicaid.

The order was a key component of Trump’s first full-fledged budget proposal, released in January.

It includes a proposal to provide states with $20 billion to expand Medicaid, the health care program for the poor, disabled and seniors.

“If you expand Medicaid it’s going to be an extension of Medicaid,” Trump said, noting that states could expand Medicaid even more to people who don’t have insurance.

“It’s a great program.

It’s going in a really big way.

We are going to expand it.

If we do it, the states are going too.”

While the White House had promised to “expand the Medicaid program in a big way,” the proposal did not explicitly say what it would look like.

The executive order also includes an effort to “improve the affordability of health insurance and provide more choice to consumers.”

The order is aimed at expanding coverage to millions of Americans who have insurance on the federal exchange or state exchanges but not on the state insurance exchange.

“I am directing the Department of Health and Human Services to expedite implementation of the Affordable Care Act, which was established by the Affordable Act,” the order reads.

“To accomplish this, the Department will expedite the implementation of state health insurance exchange rules, including through a rulemaking process, and expedite permitting, approval, and implementation of new state health exchange health insurance exchanges.

The Department will also work with state and local governments to implement health insurance marketplaces in the states, and will make available federal matching funds for implementation of this important program.”

The plan also calls for the expansion of the Medicaid expansion and says states should be allowed to use their existing Medicaid funds for any necessary improvements to the program.

The Trump administration did not immediately respond to a request for comment.

The states have not fully embraced the Trump agenda, however.

Some states have struggled to expand their Medicaid programs and others have had to delay or cut back on the expansion.

Trump has also taken steps to restrict coverage for many low-income Americans.

His administration announced plans to end coverage for people with preexisting conditions and to extend the Medicaid caps.

However, the federal health law does not specifically protect the vulnerable and sick from financial hardship, so some people may still lose coverage.

For the most part, however, the Trump health plan is expected to do more to improve the coverage and affordability of coverage.

The Affordable Care Care Act was signed into law in 2010 by President Barack Obama, who has said it would be the “gold standard” for health care coverage and cost containment.

The ACA expanded Medicaid to millions and expanded the federal insurance programs to cover millions more people.

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