Arizona Gov. Jan Brewer (R) has proposed enacting an annual $50 surcharge for obese Medicaid enrollees, a move she says would help Arizona’s financially troubled Medicaid program. If approved, the fee would be the first time a state or federally funded healthcare program for the poor fined individuals for unhealthy habits or behaviors, The Wall Street Journal reported.

The plan would mean childless obese adults who receive Medicaid would be required to follow a doctor’s weight loss plan or be charged an additional $50 a year for coverage. Smokers would be subject to the same requirement.

Brewer contends that her plan would allow Medicaid to lift its ban on certain types of organ transplant procedures, a prohibition that she put in place last year. Opponents to the fee argue that many individuals, such as those who are disabled or immobile, can’t help that they are overweight and should not be penalized, the paper reported.