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
- 34 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
- 34 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
- 29 states extend Medicaid coverage for family planning to otherwise ineligible low-income women 5
- 6 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
- 37 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
- 32 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 2016]10
Early Care and Education
- 13 states set the income eligibility limit for child care subsidies at or above 200% FPL 11
- 8 states use payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier 11
- 47 states provide families with at least 12 months of continuous eligibility for child care subsidies [FY 2017]12
- 45 states fund a pre-kindergarten program and/or supplement Head Start 13
- 15 states require districts to offer full day kindergarten 14
- 13 states require one adult for every four 18-month-olds in child care centers 15
- 19 states require one adult for every ten 4-year-olds in child care centers 15
- 11 states require one teacher for every 12 students in kindergarten classrooms 15
- 49 states have early learning standards or developmental guidelines for infants and toddlers 16
- 32 states have an infant/toddler credential or certificate 17
- 37 states require that infants and toddlers in child care centers be assigned a consistent primary caregiver 15
- 40 states have implemented a statewide Quality Rating Improvement System (QRIS) 18
- 18 states have comprehensive, free-standing standards for social emotional learning at the K-12 level 19
- 0 states require a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers 20
Parenting and Economic Supports
- 25 states exempt single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2017]21
- 32 states reduce the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2017]21
- 3 states have paid family leave for a minimum of 6 weeks with partial replacement of wages 22
- 10 states offer accrual of at least five paid sick days 23
- 11 states established a state minimum wage that meets or exceeds $10.25/hr and is indexed to inflation for a family of three 24
- 16 states set gross income eligibility limit at 200% FPL and do not have asset limits for SNAP 25
- 43 states do not charge personal income tax for single-parent families of three below the federal poverty level 26
- 30 states offer a refundable state Earned Income Tax Credit 27
- 12 states offer a refundable state dependent care tax credit 28
- 1 state offers a refundable Child Tax Credit 29
- 22 states keep copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL 11
- 19 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 2017]21
- 1 state offers a minimum of 28 weeks of Unemployment Insurance benefits 30
Data Notes and Sources
Last Updated: September 3, 2019
Send us recent developments to update your state's profile.
- 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 2017 American Community Survey, representing information from 2017. State data were calculated from the 2013-2017 American Community Survey, representing information from the years 2013 to 2017.
- Brooks, T., Roygardner, L., & Artiga, S. (2019). Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2019: 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 2, 2019).
- Guttmacher Institute. (2019). Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. https://www.guttmacher.org (accessed Feburary 11, 2019).
- Ringwalt, S. (Comp.). (2015). Summary table of states' and territories' definitions of/criteria for IDEA Part C eligibility. http://www.nectac.org (accessed August 25, 2015).
- Kaiser Commission on Medicaid and the Uninsured. (2019). Status of State Action on the Medicaid Expansion Decision. http://kff.org (accessed July 2, 2019).
- 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.
- 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.
- U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2017). The Annual EPSDT Report (Form CMS-416) for FY 2016. https://www.medicaid.gov (accessed December 11, 2017). Data were not reported for ND.
- Schulman, K. (2018). Overdue for Investment: State Child Care Assistance Policies 2018. National Women's Law Center. https://nwlc.org (accessed November 14, 2018).
- Tran, V., Minton, S., Haldar, S., & Dwyer, K. (2018). The CCDF Policies Database Book of Tables: Key Cross-State Variations in CCDF Policies as of October 1, 2017. OPRE Report 2018-106. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.urban.org (accessed December 3, 2018).
- Friedman-Krauss, A. H., Barnett, W. S., Weisenfeld, G. G., Kasmin, R., DiCrecchio, N., & Horowitz, M. (2018). The State of Preschool 2017: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed November 12, 2018).
- 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 12, 2019. 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).
- 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. (2017). Individual State Profiles. https://qualitycompendium.org (accessed January 7, 2019). The most recent data update was from November 2017.
- The Collaborative for Academic, Social, and Emotional Learning (CASEL). (2018). State Scan Scorecard Project. Chicago, IL: CASEL. https://casel.org (accessed July 15, 2019).
- 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).
- Heffernan, C., Goehring, B., Hecker, I., Giannarelli, L., & Minton, S. (2018). Welfare Rules Databook: State TANF Policies as of July 2017. OPRE Report 2018-109. 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 January 7, 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. (2019). Paid Sick Days - State and District Statutes. Washington, DC: National Partnership for Women & Families. http://www.nationalpartnership.org (accessed July 15, 2019).
- National Conference of State Legislatures. (2019). State Minimum Wages: 2019 Minimum Wage by State. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed July 15, 2019).
- Food and Nutrition Service. (2018). Broad-based Categorical Eligibility. Washington, D.C.: United States Department of Agriculture. https://www.fns.usda.gov (accessed January 14, 2019). Gehr, J. (2018). Eliminating Asset Limits: Creating Savings for Families and State Governments. Center for Law and Social Policy. https://www.clasp.org (accessed January 14, 2019).
- National Center for Children in Poverty (NCCP). (2017). 50-State Data, Income Tax Liability. Obtained internally through email correspondence with Seth Hartig dated on August 6, 2019.
- Williams, E., & Waxman, S. (2019). 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, 2019).
- National Women's Law Center. (2018). State Child and Dependent Care Tax Provisions, Tax Year 2017. Washington, DC: National Women's Law Center. https://nwlc.org (accessed December 3, 2018).
- Tax Credits for Workers and Their Families. (2019). State Tax Credits Maps. http://www.taxcreditsforworkersandfamilies.org (accessed July 15, 2019).
- Center on Budget and Policy Priorities. (2019). 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, 2019).