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.
State Choices to Promote Access
- 48 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. 4
- 48 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. 4
- 48 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. 4
- 33 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. 4
- 29 states provide lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period 4
- 23 states provide lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period 4
- 29 states provide temporary coverage to pregnant women under Medicaid until eligibility can be formally determined. 4
- 18 states provide temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined. 4
- 6 states include at-risk children in the definition of eligibility for IDEA Part C. 5
- 32 states do not require redetermination of eligibility for Medicaid/CHIP more than once a year 4
- 32 states adopted Medicaid expansion as part of the Affordable Care Act 6
- 24 states have an online dual-benefit form to apply for Medicaid and SNAP 4
- 10 states pay for screening of mothers for depression during pediatric/family medicine visits under the child's Medicaid 7
State Choices to Promote Quality
EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY2014]10
- 15 states require the recommended 7 Screenings for children <1 year
- 44 states require the recommended 4 Screenings for children 1-2 years
- 51 states require the recommended 3 Screenings for children 3-5 years
- 29 states require the recommended 4 Screenings for children 6-9 years
- 8 states require newborn screening for the 31 metabolic deficiencies/disorders and core conditions 9
Early Care and Education
State Choices to Promote Access
- 13 states set the income eligibility limit for child care subsidies at or above 200% FPL. 10
- 1 state child care subsidy reimbursement rate meets the recommended 75th percentile of the market rate 11
- 29 states redetermine the eligibility for child care subsidies no more than once per year [FY2014]12
- 23 states supplement Early Head Start 13
- 41 states fund a pre-kindergarten program and/or supplement Head Start. [FY2014]14
- 12 states require districts to offer full day kindergarten 15
State Choices to Promote Quality
- 7 states require one adult for every four 18-month-olds, and a maximum class size of eight in child care centers. 16
- 26 states allocate state or federal funds for a network of infant/toddler specialists that provide assistance to child care providers. 17
- 51 states have early learning standards or developmental guidelines for infants and toddlers. 18
- 28 states have an infant/toddler credential. 19
- 23 states require through regulation that infants and toddlers in child care centers be assigned a consistent primary caregiver. [FY 2013]20
- 15 states require one adult for every 10 4-year-olds, and a maximum class size of 20 in child care centers. 16
- 40 states have implemented a statewide Quality Rating Improvement System (QRIS) 21
- 8 states require one teacher for every 18 students in Kindergarten classrooms 22
- 44 states adopted Common Core Standards 23
- 4 states have comprehensive, free-standing standards for social emotional learning at the K-12 level [FY2015]24
Parenting and Economic Supports
State Choices to Promote Effective Parenting
- 29 states provide option to extend Medicaid coverage for family planning to otherwise ineligible low-income women 25
- 25 states exempt single parents on TANF from work requirements until the youngest child reaches age 1. [FY2014]26
- 30 states reduce the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY2014]26
State Choices to Promote Family Economic Security
- 9 states established a state minimum wage that meets or exceeds $9.10/hr and is indexed to inflation 27
- 42 states exempt single-parent families of three below the poverty level from personal income tax. 28
- 23 states offer a refundable state Earned Income Tax Credit. 29
- 11 states offer a refundable state dependent care tax credit. 30
- 26 states keep copayments for child care subsidies below 10% of family income for families of three at 150% FPL 10
- 16 states offer exemptions and/or extensions of the TANF benefit time limit for women who are pregnant or caring for a child under age 6. [FY2014]26
- 3 states have paid family leave for a minimum of 6 weeks with full or partial replacement of wages 31
- 2 states offer a minimum of 28 weeks of Unemployment Insurance benefits 32
Data Notes and Sources
Last Updated: August 22, 2016
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 2014 American Community Survey, representing information from 2014. State data were calculated from the 2010-2014 American Community Survey, representing information from the years 2010 to 2014.
- Brooks, Tricia; Miskell, Sean; Artiga, Samantha; Cornachione, Elizabeth; and Gates, Alexandra. 2016. Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. Http://files.kff.org (accessed February 29, 2016)
- 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. 2016. Status of State Action on the Medicaid Expansion Decision . Http://kff.org (accessed February 11, 2016).
- National Center for Children in Poverty. 2015. The National Center for Children in Poverty Early Childhood Mental Health (ECMH) Medicaid Survey (accessed May 16, 2016).
- U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. 2016. The Annual EPSDT Report (Form CMS-416) for FY 2014. https://www.medicaid.gov (accessed March 7, 2016).
- National Newborn Screening and Genetics Resource Center. 2014. National Newborn Screening Status Report. http://genes-r-us.uthscsa.edu (accessed March 24, 2015).
- Schulman, Karen; Blank, Helen. 2015. Building Blocks State Child Care Assistance Policies 2015. National Women's Law Center. Http://www.nwlc.org (accessed November 11, 2015). Families not eligible at 150% FPL for the following states: AL, AR, GA, ID, IA, KY, MD, MI, MT, NE and NV.
- Schulman, Karen; Blank, Helen. 2014. Turning the Corner: State Child Care Assistance Policies 2014. National Women's Law Center. http://www.nwlc.org (accessed March 3, 2015).
- Minton, Sarah; Stevens, Kathryn, Stevens; Blatt, Lorraine; and Durham, Christin. 2015. The CCDF Policies Database Book of Tables: Key Cross-State Variations in CCDF Policies as of October 1, 2014. OPRE Report 2015-95. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Http://www.acf.hhs.gov (accessed February 18, 2016).
- Colvard, Jamie; Schmit, Stephanie, Zero to Three and CLASP. 2012. Expanding Access to Early Head Start: State Initiatives for Infants and Toddlers at Risk. http://www.clasp.org (accessed August 15, 2013).
- Barnett, W.S., Carolan, M.E., Squires, J.H., Clarke Brown, K., & Horowitz, M. (2015). The state of preschool 2014: State preschool yearbook. New Brunswick, NJ: National Institute for Early Education Research. (accessed February 29, 2016)
- Education Commission of the States. 2014. Early Learning: Kindergarten Online Database. http://ecs.force.com (accessed March 3, 2015).
- National Association of Child Care Resource and Referral Agencies. 2013.We Can Do Better: Child Care Aware of America's Ranking of State Child Care Center Regulations and Oversight. http://www.naccrra.org (accessed August 14, 2013).
- Schmit, Stephanie; Matthews, Hannah, CLASP. 2013. Better for Babies: A Study of State Infant and Toddler Child Care Policies. http://www.clasp.org (accessed April 2, 2014).
- Administration for Children & Families, Office of Child Care. 2014. State/Territory Early Learning Guidelines. https://childcareta.acf.hhs.gov (accessed September 3, 2015)
- Administration for Children & Families, National Center on Child Care Professional Development Systems and Workforce Initiatives (PDW Center). 2014. State/Territory Infant/Toddler Credential Overview, April 2014. https://childcareta.acf.hhs.gov (accessed September 2, 2015)
- National Association for Regulatory Administration. 2014.The 50-State Child Care Licensing Study, 2011-2013 Edition. http://www.naralicensing.org (accessed April 8, 2014).
- QRIS National Learning Network. 2015. Current Status of QRIS in the States map. http://www.qrisnetwork.org (accessed March 16, 2015).
- Education Commission of the States. 2013. Early Learning: Kindergarten Online Database. http://ecs.force.com (accessed April 7, 2014).
- Achieve. 2015. Closing the Expectations Gap: 2013 Annual Report on the Alignment of State K-12 Policies and Practice with the Demands of College and Careers. http://www.achieve.org (accessed March 24 2015).
- Collaborative for Academic, Social, and Emotional Learning (CASEL). 2015. Identifying K-12 Standards for SEL in all 50 States. http://www.casel.org (accessed February 18, 2016).
- Guttmacher Institute. 2016. State Policies in Brief: Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. Https://www.guttmacher.org (accessed February 18, 2016).
- Huber, Erika; Cohen, Elissa; Briggs, Amanda; and Kassabian, David. 2015. Welfare Rules Databook: State TANF Policies as of July 2014. OPRE Report 2015-81. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Http://www.acf.hhs.gov (accessed March 3, 2016).
- National Conference of State Legislatures. 2016. State minimum wages: 2016 minimum wages by state. Washington, DC: NCSL. Http://www.ncsl.org (accessed February 18, 2016).
- National Center for Children in Poverty (NCCP), 50-State Policy Tracker. 2013. 50-State Data, Income Tax Liability. http://nccp.org (accessed September 3, 2015)
- Center on Budget and Policy Priorities. 2016. States Can Adopt or Expand Earned Income Tax Credits to Build a Stronger Future Economy: State Earned Income Tax Credits, 2015. Http://www.cbpp.org (accessed March 3, 2016).
- National Women's Law Center. 2014. 2014 Supplement to Making Care Less Taxing, Improving State Child and Dependent Care Tax Provisions. Washington, DC: National Women's Law Center. Http://www.nwlc.org (accessed March 24, 2015).
- National Conference of State Legislatures. 2014. State Family Medical Leave and Parental Leave Laws. Washington, DC: NCSL. Http://www.ncsl.org (accessed March 3, 2016).
- Center on Budget and Policy Priorities. 2016. Policy Basics: How Many Weeks of Unemployment Compensation Are Available? http://www.cbpp.org (accessed March 21, 2016).