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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)3: 23,161,873

Source3

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Health

State Choices to Promote Access

Source3

  • 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. [2017]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. [2017]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. [2017]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. [2017]4
  • 31 states provide lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2017]4
  • 23 states provide lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2017]4
  • 30 states provide temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2017]4
  • 20 states provide temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2017]4
  • 6 states include at-risk children in the definition of eligibility for IDEA Part C [2014]5
  • 32 states do not require redetermination of eligibility for Medicaid/CHIP more than once a year [2017]4
  • 32 states have adopted Medicaid expansion as part of the Affordable Care Act [2017]6
  • 25 states have an online dual-benefit form to apply for Medicaid and SNAP [2017]4
  • 21 states pay for maternal depression screening during pediatric/family medicine visits under the child's Medicaid [2018]7

State Choices to Promote Quality

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2016]8

  • 18 states require 7 screenings for children <1 year
  • 45 states require 4 screenings for children 1-2 years
  • 51 states require 3 screenings for children 3-5 years
  • 33 states require 4 screenings for children 6-9 years

Early Care and Education

State Choices to Promote Access

  • 12 states set the income eligibility limit for child care subsidies at or above 200% FPL [2017]9
  • 9 states reimburse center-based care at the highest quality QRIS tier above the 75th percentile of current market rates [2017]9
  • 45 states provide families with at least 12 months of continuous eligibility for child care subsidies [FY 2016]10
  • 45 states fund a pre-kindergarten program and/or supplement Head Start [FY 2016]11
  • 13 states require districts to offer full day kindergarten [2016]12

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 [2013]13
  • 47 states have early learning standards or developmental guidelines for infants and toddlers [2017]14
  • 32 states have an infant/toddler credential or certificate [2018]15
  • 23 states require that infants and toddlers in child care centers be assigned a consistent primary caregiver [2014]16
  • 15 states require one adult for every ten 4-year-olds, and a maximum class size of 20 in child care centers [2013]13
  • 40 states have implemented a statewide Quality Rating Improvement System (QRIS) [2017]17
  • 0 states require one teacher for every 12 students in kindergarten classrooms [2016]18
  • 4 states have comprehensive, free-standing standards for social emotional learning at the K-12 level [2017]19

Parenting and Economic Supports

State Choices to Promote Effective Parenting

Source3

  • 29 states extend Medicaid coverage for family planning to otherwise ineligible low-income women [2018]20
  • 26 states exempt single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2016]21
  • 31 states reduce the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2016]21
  • 2 states have paid family leave for a minimum of 6 weeks with partial replacement of wages [2016]22
  • 4 states offer accrual of at least five paid sick days [2016]23

State Choices to Promote Family Economic Security

Source3

Source8

  • 8 states established a state minimum wage that meets or exceeds $9.82/hr and is indexed to inflation for a family of three [2017]24
  • 42 states exempt single-parent families of three below the federal poverty level from personal income tax [2014]25
  • 22 states offer a refundable state Earned Income Tax Credit [2016]26
  • 12 states offer a refundable state dependent care tax credit [FY 2016]27
  • 22 states keep copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2017]9
  • 18 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 [FY 2016]21
  • 2 states offer a minimum of 28 weeks of Unemployment Insurance benefits [2017]28
  • 2 states offer a refundable Child Tax Credit [2017]29
  • 14 states set gross income eligibility limit at 200% FPL and do not have asset limits for SNAP [2016]30

  

Data Notes and Sources

Last Updated: March 29, 2018

Send us recent developments to update your state's profile.

  1. Chase-Lansdale, P. L., & Brooks-Gunn, J. (2014). Two-generation programs in the twenty-first century. The Future of Children, 24(1), 13-39.
  2. 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.
  3. National data were calculated from the 2016 American Community Survey, representing information from 2016. State data were calculated from the 2012-2016 American Community Survey, representing information from the years 2012-2016.
  4. Brooks, T., Miskell, S., Artiga, S., Cornachione, E., & Gates, A. (2017). Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2017: 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 3, 2017).
  5. 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).
  6. Kaiser Commission on Medicaid and the Uninsured. (2017). Status of State Action on the Medicaid Expansion Decision. http://kff.org (accessed February 2, 2017).
  7. Update of the National Center for Children in Poverty Early Childhood Mental Health (ECMH) Medicaid Survey reported in March 2017. http://nccp.org Data were based on 41 state survey updates as of March 15, 2018. Pending states: AR, AZ, CA, DC, GA, NM, NV, NY, OH, and TN.
  8. 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.
  9. Schulman, K., & Blank, H. (2017). Persistent Gaps: State Child Care Assistance Policies 2017. National Women's Law Center. https://nwlc.org (accessed November 2, 2017). Parents at 150% FPL ineligible for monthly child care copayments in Maryland.
  10. Minton, S., Blatt, L., Tran, V., Stevens, K., & Giannarelli, L. (2017). The CCDF Policies Database Book of Tables: Key Cross-State Variations in CCDF Policies as of October 1, 2016. OPRE Report 2017-105. 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 February 22, 2018).
  11. Barnett, W. S., Friedman-Krauss, A. H., Weisenfeld, G. G., Horowitz, M., Kasmin, R., & Squires, J. H. (2017). The State of Preschool 2016: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed December 19, 2017).
  12. Parker, E., Diffey, L., & Atchison, B. (2016). Full-day kindergarten: A look across the states. Denver, CO: Education Commission of the States. http://www.ecs.org (accessed June 23, 2017).
  13. 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://usa.childcareaware.org (accessed August 14, 2013).
  14. Administration for Children & Families, National Center on Early Childhood Quality Assurance. (2017). State Early Learning and Developmental Guidelines. https://childcareta.acf.hhs.gov (accessed December 19, 2017).
  15. Administration for Children & Families, National Center on Early Childhood Development, Teaching, and Learning. (2018). State/Territory Infant/Toddler Credential Overview, February 2018. Obtained data from staff at ZERO TO THREE.
  16. National Center on Child Care Quality Improvement & National Association for Regulatory Administration. (2015). Trends in child care center licensing regulations and policies for 2014. (Research Brief #1 ) (No. 314). Fairfax, VA: National Center on Early Childhood Quality Assurance. Https://childcareta.acf.hhs.gov (accessed June 23, 2017).
  17. QRIS National Learning Network. (2017). Current Status of QRIS in the States map. http://qrisnetwork.org (accessed February 7, 2017).
  18. Education Commission of the States. (2016). Early Learning: Kindergarten Online Database. http://ecs.force.com (accessed February 7, 2017).
  19. The Collaborative for Academic, Social, and Emotional Learning (CASEL). (2017). K-12 Learning Goals for SEL in all 50 States. https://casel.org (accessed June 23, 2017).
  20. Guttmacher Institute. (2018). Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. Https://www.guttmacher.org (accessed January 3, 2018).
  21. Giannarelli, L., Heffernan, C., Minton, S., Thompson, M., & Stevens, K. (2017). Welfare Rules Databook: State TANF Policies as of July 2016. OPRE Report 2017-82. 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 December 19, 2017).
  22. National Conference of State Legislatures. (2016). State Family Medical Leave and Parental Leave Laws. Washington, DC: National Conference of State Legislatures. Http://www.ncsl.org (accessed November 28, 2016).
  23. National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2016). 50-State Data, Family and Medical Leave. http://nccp.org (accessed July 18, 2017). *Original data were collected by the National Partnership for Women & Families.
  24. National Conference of State Legislatures. (2017). State Minimum Wages: 2017 Minimum Wage by State. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed June 23, 2017).
  25. National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2014) 50-State Data, Income Tax Liability. http://nccp.org (accessed June 23, 2017).
  26. Williams, E. (2017). States Can Adopt or Expand Earned Income Tax Credits to Build a Stronger Future Economy: State Earned Income Tax Credits, 2016. Washington, DC: Center on Budget and Policy Priorities. https://www.cbpp.org (accessed June 23, 2017).
  27. National Women's Law Center. (2017). State Child Care and Dependent Care, Tax Provisions, Tax Year 2016. Washington, DC: National Women's Law Center. https://nwlc.org (accessed December 19, 2017).
  28. Center on Budget and Policy Priorities. (2017). Policy Basics: How Many Weeks of Unemployment Compensation Are Available? https://www.cbpp.org (accessed June 23, 2017).
  29. Tax Credits for Workers and Their Families. (2017). State Tax Credits Maps. http://www.taxcreditsforworkersandfamilies.org (accessed July 18, 2017).
  30. National Center for Children in Poverty (NCCP), 50-State Policy Tracker. (2016). 50-State Data, Supplemental Nutrition Assistance Program (SNAP). http://nccp.org (accessed July 18, 2017).