An executive order signed by President Trump in January eliminated the ban on former lobbyists joining the agencies they had recently lobbied. (Jabin Botsford/The Washington Post)

Federal agencies issued just a handful of waivers exempting political appointees from conflict of interest rules in the first three months of the administration, a reflection in part of how President Trump has made it easier for lobbyists to work in agencies they once sought to influence.

Documents released by the Office of Government Ethics on Wednesday show that through April 30, just 10 Trump appointees who work outside the White House received exemptions from aspects of federal ethics rules.

Although dozens of lobbyists have joined the Trump administration, only one received an ethics waiver addressing his previous lobbying work: Lance Leggitt, the chief of staff for the Department of Health and Human Services.

That’s because an executive order that Trump signed in January did away with a rule laid down by former president Barack Obama banning lobbyists from joining agencies they had lobbied in the previous two years.

Instead, Trump’s order allows former lobbyists to enter the administration, but prohibits them for two years from working on a specific issue that they lobbied on during the previous two years.

“It was a fundamental change in the ethics executive order,” said Craig Holman, government affairs lobbyist for the watchdog group Public Citizen. “It cast some serious questions about whether the Trump administration is serious about draining the swamp.”

White House spokeswoman Lindsay E. Walters said that the “administration recognized the need for certain expertise while at the same time requiring that appointees abide by a tougher anti-revolving door policy extending the two-year post employment ban on lobbying to five years.”

At least 88 former lobbyists have been appointed or nominated to join the administration, including 56 who previously lobbied the agencies that hired them, according to a tally by the liberal group American Bridge.

Among the former lobbyists are four high-level appointees at the White House who received ethics waivers to work on policy issues on which they recently lobbied. They include former Fidelity Investments lobbyist Shahira Knight, now a tax and retirement policy adviser, and Michael Catanzaro, a one-time energy lobbyist now developing domestic energy policy for the administration.

At the Department of Health and Human Services, at least five former lobbyists other than Leggitt have been tapped to serve. They include Keagan Lenihan, a senior adviser to Secretary Tom Price who last year lobbied on Medicare and Medicaid issues for McKesson Corporation, a pharmaceutical distributor.

A department spokeswoman declined to comment.

In the case of Leggitt, he previously headed the federal health policy group for the law firm Baker Donelson, where he lobbied for hospitals and other medical clients, disclosures show.

Leggitt’s waiver allows him to work on issues on which he lobbied, though he still is barred from participating in matters involving former clients.

Another waiver went to Centers for Medicare and Medicaid Services Director Seema Verma, who worked as a health-care consultant on Medicaid reform before joining the administration.

Her firm, Indianapolis-based SVC Inc., had contracts worth nearly $8 million with the state of Indiana, and also consulted for Arkansas, Iowa, Kentucky, Ohio, South Carolina and Virginia.

As a consultant, Verma designed Indiana’s Medicaid experiment under the Affordable Care Act, under which beneficiaries must chip in toward insurance premiums and are penalized in different ways if they do not.

She also advised several other states on how they could ask CMS for permission to alter their Medicaid programs. One of those requests, from Kentucky, would make that state the first to require people on Medicaid to work — a policy Verma favors — and is currently pending before her agency.

In an ethics waiver dated March 20, Health and Human Services Secretary Tom Price determined that Verma should be allowed to weigh in on decisions affecting her former state clients, saying that excluding her expertise “would unduly disadvantage the citizens of your former state clients.” However, the waiver does not apply to specific matters that she personally worked on for Kentucky, Indiana and Iowa. Verma has recused herself from those issues.

Loosening federal restrictions on Medicaid under the ACA is a top priority for Price and his deputies. He and Verma have encouraged states to apply for waivers that were denied by the previous administration, providing them with a “checklist” for how to do it.

The new batch of ethics waivers released Wednesday shows that two members of the Cabinet received exemptions. Homeland Security Secretary John F. Kelly was granted permission to deal with matters involving Australia, despite the honorarium he received from the Australian government for his participation in a training program for military officers. And Price obtained permission to participate in certain matters involving the state of Georgia, where his wife is a state representative.

The disclosures also included exemptions granted to 13 Obama appointees last year. Among them were National Security Adviser Susan Rice, who received a waiver regarding Canadian financial investments, and Secretary of State John Kerry, who was granted one to contribute to a book of speeches commemorating former president John F. Kennedy.

“Oversight activities like this help us assess the consistency of compliance with ethics programs requirements,” said Walter M. Shaub Jr., director of the Office of Government Ethics.

Amy Goldstein and Steven Rich contributed to this report.