Read about top health issues facing states in 2018. Medicaid expenditures are 30 percent of states general fund budgets and states are looking for ways to cut costs. The opioid epidemic shows no signs of letting up, increasing the need for treatment, harm reduction programs and prevention. Questions of how to provide health service to the growing aging population and rural populations are top-of-mind in many states. Finally, state policymakers are beginning to look at the social determinants of health, searching for strategies that are more preventive in nature.