2017 marked the year that Medicaid moved to the forefront of the national conversation, as perception---and politics---caught up with the reality that no other social welfare program touches more Americans. While the robust debate remains unsettled, it's clear that the future of Medicaid coverage, and resulting expenditure impacts, will remain in the spotlight for the foreseeable future, dominating the headlines and permeating the nation's debate, according to a new report by PwC.

Despite uncertainty about potential federal Medicaid legislative changes, many states are continuing efforts to expand managed care, move ahead with payment and delivery system reforms, increase provider payment rates, and expand benefits as well as community-based long-term services and supports. Emerging trends include proposals to restrict eligibility (e.g., work requirements) and impose premiums through Section 1115 waivers, movement to include value-based purchasing requirements in MCO contracts, and efforts to combat the growing opioid epidemic, according to a Kaiser Family Foundation report.