United States Early Childhood Policy Profile

Overview

Two-generational state policies that promote health, education, and strong families can help the early development and school readiness of America’s youngest citizens. These two-generation state policies are especially important to low-income families whose young children lack access to the kinds of supports and opportunities that their more affluent peers receive.

A two-generation framework for policy design reflects extensive research that identifies the critical supports young children need over time to thrive1, 2. Most two-generation supports for young children and families are created through the collective impact of multiple policies. An example is investment in prekindergarten programs and an effective quality improvement system that promotes children’s access to high quality early care and education programs along with state policies such as the Earned Income Tax credit and minimum wage that raise the incomes of low-income working families; another is policies that ensure mental health screenings and access to quality health care for both children and parents.

This national profile aggregates the two-generation policy choices of the 50 states and the District of Columbia, showing the number of states meeting benchmarks that are favorable to the well-being of children and their families (see policy definitions for an explanation of benchmarks). The national profile includes policies that are key elements of a two-generation approach to supporting the well-being and life opportunities of young children and their parents, in the areas of health, early care and education, and parenting and economic support.

Complete source citations and endnotes are included with this profile. For easy reference, the year of the data appears in brackets. To show the range of variation among states, some graphs identify the states with the highest and lowest percentages alongside the national average. Data tables also allow for comparisons across states on each policy choice.

Users who wish to examine additional policies specific to their state, within a two-generation framework, can find suggestions in State Policies through a Two-Generation Lens: Strengthening the Collective Impact of Policies that Affect the Life Course of Young Children and their Parents.

Young children (under age 6)1: 59,703

Percent of children under 6 by income levels, 2022

Source1

Percent of children under 6 by race/ethnicity, 2022

Source1

*Native Hawaiians/Pacific Islanders make up 0.2% of children under 6.

Percent of children under 6 by parents’ immigration status, 2022*

Source1

*If one of the parents is an immigrant, that case is counted under the immigrant group.

Health and Development Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

49 states set the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) for children age less than 1 year [2023]2

49 states set the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) for children ages 1 to 5 years [2023]2

49 states set the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) for children ages 6 to 18 years [2023]2

35 states set the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL) for pregnant women [2023]2

35 states provide lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2023]2

26 states provide lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2023]2

22 states provide temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2021]3

30 states provide temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2022]4

17 states provide 12-month continuous eligibility for both Medicaid and CHIP (for child) [2023]5

46 states provide 12 months of postpartum Medicaid coverage for all eligible women [2024]6

23 states extend Medicaid coverage for family planning to otherwise ineligible low-income women [2023]7

6 states include at-risk children in the definition of eligibility for IDEA Part C [2023]8

41 states have adopted Medicaid expansion as part of the Affordable Care Act [2023]9

32 states have an online dual-benefit form to apply for Medicaid and SNAP [2023]2

43 states require or recommend maternal depression screening as part of well-child visits under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit [2023]10

28 states have at least one Help Me Grow affiliate site that has fully implemented a centralized access point [2023]11

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics

41 states require 7 screenings for children <1 year [FY 2021]12

51 states require 4 screenings for children 1-2 years [FY 2021]12

51 states require 3 screenings for children 3-5 years [FY 2021]12

49 states require 4 screenings for children 6-9 years [FY 2021]12

Percent of children under 6 who lack health insurance, 2022

Source1

Percent of children under 3 receiving Early Intervention services by race/ethnicity in 2021-2022*

Source13

*EI rates are not displayed where the cell size is small as the data are not reliable.

Early Care and Education Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

18 states set the income eligibility limit for child care subsidies at or above 85% SMI [2022]14

25 states use payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier [2022]14

45 states fund a pre-kindergarten program [2022]15

13 states supplement Head Start [2022]15

18 states require districts to offer full day kindergarten [2023]16

12 states require one adult for every four 18-month-olds in child care centers [2023]17

19 states require one adult for every ten 4-year-olds in child care centers [2023]17

0 states require one teacher for every 12 students in kindergarten classrooms [2023]16

23 states require that infants and toddlers in child care centers be assigned a consistent primary caregiver [2023]17

45 states have implemented a statewide Quality Rating Improvement System (QRIS) [2024]18

27 states have comprehensive, free-standing standards for social emotional learning at the K-12 level [2023]19

0 states require a minimum of a bachelor’s degree for lead teachers in public pre-K programs and licensed child care centers [2020]20

Parenting and Economic Supports Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

23 states exempt single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2022]21

32 states reduce the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2022]22

30 states allow TANF participants to receive benefits for a maximum of 60 months in their lifetime without limits on continuous coverage [FY 2022]23

14 states have paid family leave for a minimum of 6 weeks with partial replacement of wages [2023]24

7 states offer accrual of at least five paid sick days [2023]25

9 states established a state minimum wage that meets or exceeds $14.00/hr and is indexed to inflation for a family of three [2024]26

19 states set gross income eligibility limit at 200% FPL and do not have asset limits for SNAP [2022]27

39 states do not charge personal income tax for single-parent families of three below the federal poverty level [TY 2022]28

15 states offer a refundable state dependent care tax credit [TY 2023]29

28 states offer a refundable state Earned Income Tax Credit [2023]30

11 states offer a refundable Child Tax Credit [2024]31

33 states keep copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2022]14

8 states offer exemptions and/or extensions of the TANF benefit time limit for recipients who are pregnant [FY 2022]32

10 states offer exemptions and/or extensions of the TANF benefit time limit for recipients caring for a child under 6 months of age [FY 2022]21

1 state offers a minimum of 28 weeks of Unemployment Insurance benefits [2024]33

8 states fund a housing program that provides rental assistance to low-income families with children to avoid eviction or homelessness [2024]34

Percent of low-income children under 6 by parents’ employment status, 2022

Source1

Education levels of mothers with children under 6, 2022

Source1

Maximum annual TANF benefit for a family of three, for FY 2022

Source35

*The graph shows the US average together with states that have the highest and lowest benefit amounts.

Data Notes and Sources

  1. State data were calculated from the 2018-2022 American Community Survey, representing information from the years 2018 to 2022. National data were calculated from the 2022 American Community Survey, representing information from 2022.
  2. Brooks, T., Gardner, A., Yee, P., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2023). Medicaid and CHIP eligibility, enrollment, and renewal policies as states prepare for the unwinding of the pandemic-era continuous enrollment provision. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. Retrieved June 5, 2023, from https://files.kff.org
  3. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2021). Presumptive eligibility. Retrieved July 14, 2022, from https://www.medicaid.gov
  4. Brooks, T., Gardner, A., Osorio, A., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2022). Medicaid and CHIP eligibility and enrollment policies as of January 2022: Findings from a 50-state survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. Retrieved Feburary 8, 2023, from https://files.kff.org
  5. KFF. (2023). State health facts. State adoption of 12-month continuous eligibility for children's Medicaid and CHIP. Retrieved July 17, 2023, from https://www.kff.org
  6. Kaiser Family Foundation. (2024). Medicaid postpartum coverage extension tracker. Retrieved March 8, 2024, from https://www.kff.org
  7. Guttmacher Institute. (2023). Medicaid family planning eligibility expansions. Retrieved September 26, 2023, from https://www.guttmacher.org
  8. The Early Childhood Technical Assistance Center. (n.d.). State and jurisdictional eligibility definitions for infants and toddlers with disabilities under IDEA Part C. Retrieved February 15, 2023, from https://ectacenter.org
  9. Kaiser Commission on Medicaid and the Uninsured. (2023). Status of state action on the Medicaid expansion decision. Retrieved July 17, 2023, from https://www.kff.org
  10. National Academy for State Health Policy. (2023). Medicaid policies for maternal depression screening (MDS) during well-child visits, by state. Retrieved July 17, 2023, from https://nashp.org NCCP reviewed state policies for AR, FL, KS, NE, and NH as of April 10, 2024.
  11. Help Me Grow National Center. (2023). Help Me Grow network affiliates. https://helpmegrownational.org Email correspondences from Melissa Miller on July 31, 2023.
  12. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2021). The annual EPSDT report (Form CMS-416) for FY 2021. Retrieved May 23, 2023, from https://www.medicaid.gov
  13. Early Intervention (EI) rates were calculated by using data from three sources: 2021-2022 EI cumulative counts collected by the US Department of Education, 2018-2022 American Community Survey data, and the 2021-2022 American Community Survey data. EI rates are not displayed where cell size for the numerator (number of children in EI) is missing, or cell size for the denominator (total number of children) is less than 200. To access EI data, please go to IDEA Section 618 Data Products: Table 11 Cumulative count of infants and toddlers birth through age 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state 2021-2022. https://data.ed.gov . To access ACS data, please visit the US Census Bureau data tool. https://data.census.gov
  14. Schulman, K. (2023). Precarious progress: State child care assistance policies 2022. National Women's Law Center. Retrieved June 13, 2023, from https://nwlc.org
  15. Friedman-Krauss, A. H., Barnett, W. S., Hodges, K. S., Garver, K. A., Weisenfeld, G. G., Gardiner, B.A., & Jost, T. M. (2023). The state of preschool 2022: State preschool yearbook. National Institute for Early Education Research. Retrieved August 24, 2023, from https://nieer.org
  16. Education Commission of the States. (2023). State education policy tracking. Retrieved August 24, 2023, from https://www.ecs.org NCCP also referenced ECS's 2023 50-State Comparison: State Kindergarten-Through-Third-Grade Policies. https://reports.ecs.org
  17. NCCP's review of state child care licensing regulations as of August 23, 2023. Policies were retrieved from the National Database of Child Care Licensing Regulations. https://childcareta.acf.hhs.gov
  18. The Quality Compendium. (2024). Individual state profiles. The BUILD Initiative. Retrieved March 5, 2024, from https://qualitycompendium.org
  19. Collaborative for Academic, Social, and Emotional Learning (CASEL). (2023). Social-emotional learning policy at the state level. Retrieved July 31, 2023, from https://casel.org
  20. McLean, C., Austin, L.J.E., Whitebook, M., & Olson, K.L. (2021). Early childhood workforce index 2020. Center for the Study of Child Care Employment, University of California, Berkeley. Retrieved March 10, 2021, from https://cscce.berkeley.edu
  21. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov
  22. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov NCCP reviewed state policies for OR and WI as of March 27, 2024.
  23. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov NCCP reviewed state policies for AR, CT, IN, NM, and NY as of April 10, 2024.
  24. National Partnership for Women & Families. (2023). State paid family and medical leave insurance laws. Retrieved March 20, 2024, from https://www.nationalpartnership.org
  25. National Partnership for Women & Families. (2023). Paid sick days - State and district statutes. Retrieved March 14, 2024, from https://nationalpartnership.org
  26. National Conference of State Legislatures. (2024). State minimum wages. Retrieved March 5, 2024, from http://www.ncsl.org
  27. Aussenberg, R.A., & Falk, G. (2022). The Supplemental Nutrition Assistance Program (SNAP): Categorical eligibility. Congressional Research Service. Retrieved August 28, 2023, from https://crsreports.congress.gov
  28. NCCP's calculations derived from output generated by the National Bureau of Economic Research Internet TAXSIM Version 35, available at https://taxsim.nber.org for the 2022 tax year. For a description of the TAXSIM model, see Feenberg, D. and Coutts, E. (1993). An Introduction to the TAXSIM Model. Journal of Policy Analysis and Management 12(1): 189-194.
  29. National Women's Law Center. (2024). States can make care less taxing, Tax year 2023. Retrieved February 27, 2024, from https://nwlc.org
  30. Urban Institute. (2023). State earned income tax credits. Retrieved August 24, 2023, from https://www.urban.org NCCP also referenced the Tax Policy Center's State EITC as percentage of the federal EITC. Retrieved August 24, 2023, from https://www.taxpolicycenter.org
  31. National Conference of State Legislatures. (2024). Child tax credit overview. Retrieved March 13, 2024, from https://www.ncsl.org NCCP reviewed state policies for MD as of May 8, 2024, from https://montgomerycountymd.gov
  32. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov NCCP reviewed state policies for SC as of March 27, 2024.
  33. Center on Budget and Policy Priorities. (2024). Policy basics: How many weeks of unemployment compensation are available? Retrieved April 5, 2024, from https://www.cbpp.org
  34. NCCP reviewed state funded rental housing programs as of April 16, 2024. Programs were retrieved from the National Low Income Housing Coalition Database. https://nlihc.org
  35. Thompson, G. T., Azevedo-McCaffrey, D., & Carr, D. (2023). Increases in TANF cash benefit levels are critical to help families meet rising costs. Retrieved March 1, 2023, from https://www.cbpp.org

Last updated on May 1, 2024