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
- 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
- 31 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
- 30 states provide temporary coverage to pregnant women under Medicaid until eligibility can be formally determined 4
- 20 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 have adopted Medicaid expansion as part of the Affordable Care Act 6
- 25 states have an online dual-benefit form to apply for Medicaid and SNAP 4
- 12 states pay for maternal depression screening 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 [FY 2015]8
- 18 states require the recommended 7 Screenings for children <1 year
- 45 states require the recommended 4 Screenings for children 1-2 years
- 51 states require the recommended 3 Screenings for children 3-5 years
- 33 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
- 9 states set the income eligibility limit for child care subsidies at or above 200% FPL 10
- 5 states reimburse center-based care at the highest quality QRIS tier above the 75th percentile of current market rates 10
- 32 states redetermine the eligibility for child care subsidies no more than once per year [FY 2015]11
- 44 states fund a pre-kindergarten program and/or supplement Head Start [FY 2015]12
- 12 states require districts to offer full day kindergarten 13
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 14
- 45 states have early learning standards or developmental guidelines for infants and toddlers 15
- 28 states have an infant/toddler credential 16
- 23 states require through regulation that infants and toddlers in child care centers be assigned a consistent primary caregiver [FY 2013]17
- 15 states require one adult for every 10 4-year-olds, and a maximum class size of 20 in child care centers 14
- 40 states have implemented a statewide Quality Rating Improvement System (QRIS) 18
- 0 states require one teacher for every 12 students in kindergarten classrooms 19
- 44 states have adopted Common Core Standards 20
- 3 states have comprehensive, free-standing standards for social emotional learning at the K-12 level 21
Parenting and Economic Supports
State Choices to Promote Effective Parenting
- 28 states provide option to extend Medicaid coverage for family planning to otherwise ineligible low-income women 22
- 26 states exempt single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2015]23
- 31 states reduce the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2015]23
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 24
- 42 states exempt single-parent families of three below the poverty level from personal income tax 25
- 23 states offer a refundable state Earned Income Tax Credit 26
- 12 states offer a refundable state dependent care tax credit [FY 2015]27
- 18 states keep copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL 10
- 14 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 2015]23
- 2 states have paid family leave for a minimum of 6 weeks with full or partial replacement of wages 28
- 2 states offer a minimum of 28 weeks of Unemployment Insurance benefits 29
Data Notes and Sources
Last Updated: March 31, 2017
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 2011 American Community Survey, representing information from 2011. State data were calculated from the 2009-2011 American Community Survey, representing information from the years 2009 to 2011.
- 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).
- 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. (2017). Status of State Action on the Medicaid Expansion Decision. http://kff.org (accessed February 2, 2017).
- Smith, S., Granja, M., Ekono, M., Robbins, T., & Nagarur, M. (2017). Using Medicaid to Help Young Children and Parents Access Mental Services: Results of a 50-State Survey. New York: National Center for Children in Poverty, Mailman School of Public Health, Columbia University (accessed February 7, 2017).
- U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2016). The Annual EPSDT Report (Form CMS-416) for FY 2015. https://www.medicaid.gov (accessed December 12, 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, K., & Blank, H. (2016). Red Light Green Light: State Child Care Assistance Policies 2016. National Women's Law Center. https://nwlc.org (accessed December 14, 2016). Parents at 150% FPL ineligible in the following states: AL, AR, GA, ID, IA, MD, and MT.
- Stevens, K., Minton, S., Blatt, L., & Giannarelli, L. (2016). The CCDF Policies Database Book of Tables: Key Cross-State Variations in CCDF Policies as of October 1, 2015. OPRE Report 2016-94. 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, 2017).
- Barnett, W. S., Friedman-Krauss, A. H., Gomez, R. E., Horowitz, M., Weisenfeld, G. G., & Squires, J. H. (2016). The State of Preschool 2015: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research. http://nieer.org (accessed December 12, 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://usa.childcareaware.org (accessed August 14, 2013).
- Administration for Children & Families, Office of Child Care. (2016). State/Territory Early Learning Guidelines. https://childcareta.acf.hhs.gov (accessed February 3, 2017).
- 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. (2017). Current Status of QRIS in the States map. http://qrisnetwork.org (accessed February 7, 2017).
- Education Commission of the States. (2016). Early Learning: Kindergarten Online Database. http://ecs.force.com (accessed February 7, 2017).
- 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).
- CASEL. 2015. SEL in Your State: State Scan http://www.casel.org (accessed March 16, 2015).
- Guttmacher Institute. (2017). State Policies in Brief: Medicaid Family Planning Eligibility Expansions. New York, NY: Guttmacher Institute. https://www.guttmacher.org (accessed February 8, 2017).
- Cohen, E., Minton, S., Thompson, M., Crowe, E., & Giannarelli, L. (2016). Welfare Rules Databook: State TANF Policies as of July 2015. OPRE Report 2016-67. 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 7, 2016).
- National Conference of State Legislatures. (2016). State minimum wages: 2016 minimum wages by state. Washington, DC: National Conference of State Legislatures. http://www.ncsl.org (accessed February 18, 2016).
- National Center for Children in Poverty, 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. 2016. State Child Care and Dependent Care, Tax Provisions, Tax Year 2015. Washington, DC: National Women's Law Center. https://nwlc.org (accessed December 6, 2016).
- 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).
- 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).