United States Early Childhood Profile
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.
Health and Development
- 49 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for children age less than 1 year. 4
- 49 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for children ages 1 to 5 years. 4
- 49 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for children ages 6 to 18 years. 4
- 35 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for pregnant women. 4
- 35 states provide lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period 4
- 25 states provide lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period 4
- 20 states provide temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined 4
- 30 states provide temporary coverage to pregnant women under Medicaid until eligibility can be formally determined 4
- 30 states extend Medicaid coverage for family planning to otherwise ineligible low-income women 5
- 7 states include at-risk children in the definition of eligibility for IDEA Part C 6
- 32 states do not require redetermination of eligibility for Medicaid/CHIP more than once a year 4
- 38 states have adopted Medicaid expansion as part of the Affordable Care Act 7
- 25 states have an online dual-benefit form to apply for Medicaid and SNAP 4
- 39 states pay for maternal depression screening during pediatric/family medicine visits under the child's Medicaid 8
- 18 states have at least one Help Me Grow affiliate site that has fully implemented a centralized access point 9
EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2018]10
- 26 states require 7 screenings for children <1 year
- 48 states require 4 screenings for children 1-2 years
- 51 states require 3 screenings for children 3-5 years
- 43 states require 4 screenings for children 6-9 years
Early Care and Education
- 14 states set the income eligibility limit for child care subsidies at or above 200% FPL 10
- 13 states use payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier 10
- 50 states provide families with at least 12 months of continuous eligibility for child care subsidies [FY 2018]11
- 45 states fund a pre-kindergarten program 12
- 12 states supplement Head Start 12
- 15 states require districts to offer full day kindergarten 13
- 13 states require one adult for every four 18-month-olds in child care centers 14
- 20 states require one adult for every ten 4-year-olds in child care centers 
- 10 states require one teacher for every 12 students in kindergarten classrooms 14
- 50 states have early learning standards or developmental guidelines for infants and toddlers 15
- 32 states have an infant/toddler credential or certificate 16
- 38 states require that infants and toddlers in child care centers be assigned a consistent primary caregiver 14
- 42 states have implemented a statewide Quality Rating Improvement System (QRIS) 17
- 19 states have comprehensive, free-standing standards for social emotional learning at the K-12 level 18
- 0 states require a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers 19
Parenting and Economic Supports
- 26 states exempt single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2018]20
- 34 states reduce the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2018]20
- 3 states have paid family leave for a minimum of 6 weeks with partial replacement of wages 21
- 12 states offer accrual of at least five paid sick days 22
- 8 states established a state minimum wage that meets or exceeds $11.50/hr and is indexed to inflation for a family of three 23
- 15 states set gross income eligibility limit at 200% FPL and do not have asset limits for SNAP 24
- 43 states do not charge personal income tax for single-parent families of three below the federal poverty level 25
- 23 states offer a refundable state Earned Income Tax Credit 26
- 12 states offer a refundable state dependent care tax credit 27
- 2 states offer a refundable Child Tax Credit 28
- 26 states keep copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL 10
- 17 states offer exemptions and/or extensions of the TANF benefit time limit for women who are pregnant or caring for a child under 6 months of age [FY 2018]20
- 1 state offers a minimum of 28 weeks of Unemployment Insurance benefits 29
- 6 states fund a housing program that provides rental assistance to low-income families with children to avoid eviction or homelessness 30
Data Notes and Sources
- Chase-Lansdale, P. L., & Brooks-Gunn, J. (2014). Two-generation programs in the twenty-first century. The Future of Children, 24(1), 13-39.
- Shonkoff, J. P., & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and psychopathology, 25(4pt2), 1635-1653.
- National data were calculated from the 2018 American Community Survey, representing information from 2018. State data were calculated from the 2014-2018 American Community Survey, representing information from the years 2014 to 2018
- Brooks, T., Roygardner, L., Artiga, S., Pham, O., & Dolan, R. (2020). Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://files.kff.org (accessed July 7, 2020).
- Guttmacher Institute. (2020). Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. https://www.guttmacher.org (accessed January 22, 2020).
- NCCP collected this data point as part of a 50-state survey on supports for infant-toddler mental health in state Part C programs as of February 21, 2020.
- Kaiser Commission on Medicaid and the Uninsured. (2020). Status of State Action on the Medicaid Expansion Decision. https://www.kff.org (accessed July 1, 2020).
- Smith, S., Granja, M.R., Nguyen, U., Rajani, K. (2018). How States Use Medicaid to Cover Key Infant and Early Childhood Mental Health Services: Results of a 50-State Survey (2018 Update). New York: National Center for Children in Poverty, Mailman School of Public Health, Columbia University; National Academy for State Health Policy. (2018). Medicaid Policies for Maternal Depression Screening (MDS) during Well-Child Visits, by State. https://healthychild.nashp.org (accessed January 22, 2020).
- Help Me Grow National Center. (2019). Help Me Grow Network Affiliates. https://helpmegrownational.org Email correspondences from Stephanie Luczak on April 4, 2019 and May 17, 2019.
- Schulman, K. (2019). Early Progress: State Child Care Assistance Policies 2019. National Women's Law Center. https://nwlc.org (accessed November 12, 2019). Texas data were updated based on email correspondence with Shay Everitt at the Texas Workforce Commission on September 10, 2020; see the Workforce Development Letter regarding child care provider maximum reimbursement rate increases.
- Tran, V., Dwyer, K., & Minton, S. (2019). Key Cross-State Variations in CCDF Policies as of October 1, 2018: The CCDF Policies Database Book of Tables. OPRE Report 2019-117. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov January 30, 2020).
- Friedman-Krauss, A. H., Barnett, W. S., Garver, K. A., Hodges, K. S., Weisenfeld, G. G., & DiCrecchio, N. (2019). The State of Preschool 2018: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed October 31, 2019).
- Diffey, L. (2018). 50-State Comparison: State Kindergarten-Through-Third-Grade Policies. Denver, CO: Education Commission of the States. http://ecs.force.com (accessed June 29, 2018).
- NCCP's review of state child care licensing regulations as of August 17, 2020. Policies were retrieved from the National Database of Child Care Licensing Regulations. https://childcareta.acf.hhs.gov
- Administration for Children & Families, National Center on Early Childhood Quality Assurance. (2019). Early Learning and Developmental Guidelines. https://childcareta.acf.hhs.gov (accessed August 1, 2019). Texas data were updated based on email correspondence with Shay Everitt at the Texas Workforce Commission on September 10, 2020; see the Texas Infant, Toddler, and Three-Year-Old Early Learning Guidelines and Training.
- Administration for Children & Families, National Center on Early Childhood Development, Teaching, and Learning. (2018). State/Territory Infant/Toddler Credential Overview, May 2018. https://childcareta.acf.hhs.gov (accessed December 3, 2018).
- The Quality Compendium. (2020). Individual State Profiles. https://qualitycompendium.org (accessed July 6, 2020).
- The Collaborative for Academic, Social, and Emotional Learning (CASEL). (2020). State Scan Scorecard Project. Chicago, IL: CASEL. https://casel.org (accessed July 15, 2020).
- Whitebook, M., McLean, C., Austin, L.J.E., & Edwards, B. (2018). Early Childhood Workforce Index - 2018. Berkeley, CA: Center for the Study of Child Care Employment, University of California, Berkeley. http://cscce.berkeley.edu (accessed July 25, 2018).
- Goehring, B., Heffernan, C., Minton, S., & Giannarelli, L. (2019). Welfare Rules Databook: State TANF Policies as of July 2018. OPRE Report 2019-83. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov (accessed October 22, 2019).
- National Partnership for Women & Families. (2019). State Paid Family and Medical Leave Insurance Laws. Washington, DC: National Partnership for Women & Families. http://www.nationalpartnership.org (accessed July 15, 2019).
- National Partnership for Women & Families. (2020). Paid Sick Days - State and District Statutes. Washington, DC: National Partnership for Women & Families. http://www.nationalpartnership.org (accessed July 15, 2020).
- National Conference of State Legislatures. (2020). State Minimum Wages: 2020 Minimum Wage by State. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed January 30, 2020).
- Food and Nutrition Service. (2019). Broad-based Categorical Eligibility. Washington, DC: U.S. Department of Agriculture. https://www.fns.usda.gov (accessed Feburary 6, 2020). NCCP also reviewed state policies for AK, AR, KS, LA, MS, MO, SD, TN, UT, VA, and WY.
- National Center for Children in Poverty (NCCP). (2018). 50-State Data, Income Tax Liability. Obtained internally through email correspondence with Seth Hartig dated on July 21, 2020.
- Williams, E., Waxman, S., & Legendre, J. (2020). States Can Adopt or Expand Earned Income Tax Credits to Build a Stronger Future Economy. Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed July 15, 2020).
- National Women's Law Center. (2019). Making Care Less Taxing: State Child and Dependent Care Tax Provisions, Tax Year 2018. Washington, DC: National Women's Law Center. https://nwlc.org (accessed October 24, 2019).
- Tax Credits for Workers and Their Families. (2020). State Tax Credits Maps. http://www.taxcreditsforworkersandfamilies.org (accessed July 15, 2020).
- Center on Budget and Policy Priorities. (2020). Policy Basics: How Many Weeks of Unemployment Compensation Are Available? Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed July 15, 2020).
- NCCP's review of state-funded rental housing programs as of August 17, 2020. Programs were retrieved from the National Low Income Housing Coalition Database. https://reports.nlihc.org Recent funding information was obtained through email correspondence with state contacts for DC, IL, MA, and NJ.