50-State Early Childhood Policy Progress and Landscape Report

Alliance state grantees shared highlights from the year in the broad areas of maternal and child health, early care and education, and family supports. Whether it was a new policy passed, an increase in funding, or an improvement to an existing policy, these shifts will improve lives for young children and their families.

Percentage of States Highlighting a Win, by Issue Area

In the annual review of early childhood policy and progress in states, the District of Columbia is counted as a states (n-51). 

Maternal and Child Health

Advocates reported a policy win in 27 states, and 18 states increased the state budget for maternal and child health.

Several states increased access to early intervention and special education services.

• • Georgia, Rhode Island, and Minnesota increased reimbursement rates for certain early intervention providers.

  • Texas advocates collaborated with state officials to include “developmental delay” as an eligibility category for special education services, a policy modeled after other states. Definition and governance changes also increased eligibility for and access to early intervention and mental health supports in New Hampshire, Maine, and Washington.

  • Maine passed significant changes for responsibility and oversight of the educational services for young children with disabilities.

More states adopted continuous coverage for Medicaid in the early years.  

• • California, New York, and Pennsylvania, followed their peers in extending continuous Medicaid coverage during the early childhood years, ensuring access to health care without interruptions due to administrative burdens. While the 2023 Consolidated Appropriations Act requires all states to provide 12 months of continuous health coverage for children in Medicaid and the Children’s Health Insurance Program (CHIP), a growing number of state legislatures have approved continuous enrollment for multiple years. The Centers for Medicare & Medicaid Services (CMS) has approved waivers to allow multi-year continuous coverage for nine states, while three additional states have legislative approval but have not yet submitted a waiver.

Prenatal care improved.

With the addition of Delaware, Virginia, and Vermont, a total of 27 states plus Washington, DC, have already implemented—or are in the process of implementing—Medicaid coverage for doula care. To support states in implementing doula coverage through Medicaid, Alliance partner Elephant Circle offered a webinar on the topic in March 2024. 

Massachusetts, Colorado, and Illinois passed bills that will increase access to midwifery care, a model that monitors the physical, psychological, and social well-being of mothers and pregnant people throughout the childbearing cycle, resulting in fewer interventions and positive impacts on health outcomes in the United States if adopted more broadly.

• • Michigan allies are advancing permanent policy solutions to address maternal health equity. Perinatal Quality Collaboratives, designed to improve outcomes for families during preconception, birth, and postpartum, are now established by statute, blood pressure monitors must be covered by Medicaid and private insurance for pregnant/postpartum patients, and mental health screenings for new mothers are required as part of postpartum obstetrics or pediatric appointments, among more than nine maternal health bills passed in 2024.
  • Minnesota passed a grant program targeted specifically at increasing access to culturally congruent care for Black and Indigenous families.

States increased access to home visiting supports.

Several states expanded evidence-based home visiting, a practice that has a demonstrable positive impact on the health of mothers and newborns.

• • $1 million to expand the rural home-visiting pilot in Georgia.
  • $3.72 million in new funding for home visiting programs in Michigan, including a $3.3 million increase for the state’s Maternal Infant Health Program and $420,000 in one-time funding for the Nurse Family Partnership program.
  • Ohio piloted a new universal nurse home visiting program with the goal of serving 4,000 families.
  • $2.5 million appropriation in Arizona for the nurse-family partnership programs to become non-lapsing through FY 2027.
  • Nebraska dedicated $1.4 million from the Medicaid Managed Care Excess Profit Fund to fund community-specific universal nurse home-visiting programs ($500,000) and evidence-based programs eligible for MIECHV matching funds ($900,000.)
  • Oregon fully funded the Nurse Family Partnerships program by $3.2 million as part of the direct investments in prevention programs.
  • Rhode Island enacted a permanent Medicaid rate increase for the First Connections family home visiting program, the first permanent rate increase in 22 years.

Early Care and Education (ECE)

Alliance state grantees reported at least one ECE policy win in 45 states, with 33 states increasing the state budget for early care and education. Below are some highlights from 2024.

Numerous states improved child care access.

As federal pandemic relief funds for child care expired in 2024, early childhood advocates in many states were able to secure state funding to address the gap.  While, in most cases, state funding was not sufficient to replace all the federal funds, these wins demonstrate that governors and state legislators—in both conservative and progressive led states—see improving child care access and quality as an appropriate purpose for state funding.

There were numerous funding increases, and Alliance allies highlighted the following:

• • $12 million in Arizona for the child care subsidy program, the first state investment in nearly 15 years.
  • $23 million in Florida for School Readiness Plus, which allows families up to 100% of the state median income who are enrolled in the child care subsidy program to continue receiving the subsidy. The state also allocated $200 million to align the subsidy rates closer to the cost of care, instead of the market rate.
  • $59 million in Kentucky for their Child Care Assistance Program.
  • More than $10 million in Maine to meet increased demand due to an increase in eligibility for child care subsidies from 85% of the state’s median income to 125% beginning July 1, 2024.
  • $270 million of new state funds in Maryland’s FY25 budget for the Child Care Scholarship Program.
  • $997 million in FY25 for New York’s Child Care Assistance Program, more than doubling the state investment of $459 million for FY24. New York also added $100 million in funding to expand pre-k slots throughout the state, which will create about 8,000 more pre-k seats in the state.
  • More than $170 million in Oregon to address a waitlist for child care that resulted from expansion of eligibility enacted in 2021: $99 million allocated immediately to tackle existing caseload issues, and an additional $72 million designated in a special purpose account (SPA) to potentially reduce the waitlist next year.
  • More than $366 million in FY25 and $461 million in FY26 in Virginia’s general fund to support early care and education. Combined with ongoing federal support, the state will commit more than $1.1 billion over the biennium toward child care services for low to moderate income families.

The early care and education workforce continues to be a priority for state leaders.

State advocates highlighted the following wins from 2024.

• • In 2022, Kentucky passed a policy to extend subsidy eligibility to child care teachers and staff, regardless of income. Since 2022, early childhood advocates and policymakers in many states have advanced this idea as a way to attract and retain early childhood educators. Even though the strategy doesn’t directly increase educators’ compensation, it does provide them with some financial relief. In 2024, states including Arkansas, Indiana, Maine, Nebraska, New Hampshire, Utah, and Washington, DC implemented this strategy or passed policies to enact it. Others, including Iowa, Rhode Island, Washington State, and of course, Kentucky continued to allocate funding for it. In Kentucky, the state is providing more than $26 million to provide this benefit to child care staff.
  • Illinois increased funding for its Smart Start Workforce Grants by 27 percent to $158.5 million.
  • Colorado created a new $1200 tax credit specifically for care workers, estimated to impact more than 35,000 licensed child care workers, Family, Friend, and Neighbor (FFN) child care workers, and qualifying personal care aides and home care workers.
  • In Georgia, advocates helped secure almost $100 million in additional funding to make critical improvements to Georgia’s Lottery-funded pre-k program that improves working conditions for its educators, including restoring class size to 20 students per class, increasing salaries for lead and assistant teachers, and funding to support classroom costs.

Family Supports

Healthy young children need healthy and economically stable families, and state advocates continued to work on policies related to tax credits, making federal benefits more accessible, guaranteed income pilots, housing, addressing hunger, paid leave programs, and child welfare systems.

Advocates reported a family support policy win in 22 states, and 14 states increased state funding for family support programs.

Family incomes increased due to increased tax credits, including Earned Income Tax Credits (EITCs), Child Tax Credits (CTC), and Child and Dependent Care Tax Credits (CDCTC):

• • Illinois established a permanent state CTC for families who are eligible for the federal EITC with children under age 12, and it is expected to impact more than 800,000 households and lift nearly 14,000 children out of poverty.
  • New York added a one-time supplement to their Empire State Child Tax Credit that will impact one million families. one million families.
  • Utah expanded its CTC for families with young children to include 4-year-olds.
  • Colorado created a new tax credit, in addition to their state EITC and CTC—nearly half of Colorado families will benefit from the new Family Affordability Tax Credit, with the highest benefits going to the lowest-income families and with the youngest children.
  • Both Kansas and Wisconsin raised their state Child and Dependent Care Tax Credits (CDCTC) as a percentage of the federal CDCTC—Kansas from 25 percent to 50 percent, and Wisconsin from 50percent to 100 percent of the federal credit. A few other states are seeing tax credits for families as a potential focus for the 2025 session.

A few states used the flexibility of Temporary Assistance to Needy Families (TANF) to make positive changes.

• • Maine increased the possible maximum monthly benefit allowed under TANF.
  • Rhode Island increased monthly cash benefits from TANF, repealed the full family sanction rule, and increased the income disregard.
  • Michigan dedicated $20 million of its TANF funds to support the city of Flint’s Rx Kids guaranteed-income pilot and to allow other cities to support families during the perinatal period and into the child’s first year of life.

At least three states passed laws that will better support renters at risk of eviction (who often have young children).

• • Colorado reduced court fees and will collect better data on evictions.
  • Georgia’s new Safe at Home Act requires that rental properties are fit for habitation, prevents cooling from being cut off, prohibits security deposits larger than two months’ rent, gives a tenant time to pay before an eviction proceeding is filed, and puts new requirements on how eviction notices must be delivered to tenants.
  • Idaho passed a law that will allow dismissed eviction filings to be shielded from public viewing after three years as long as no appeal is pending.

In several states, advocates made significant gains in the area of child nutrition.

• • Alabama will fund the Summer Electronic Benefits Program (EBT) in 2025, drawing down a federal match to help feed school-aged children in the summer months.
  • In Missouri, advocates successfully won a reversal on the state’s original decision to decline to participate in Summer EBT.
  • Oregon passed funding to ensure that home-based child care providers can continue to access federal reimbursement for food they serve to children in care.
  • Virginia established a Commission to End Hunger.
  • Kansas advocates defeated a bill that would have required non-custodial parents to cooperate with child support enforcement to receive food assistance.

While eight states improved access to existing Paid Family and Medical Leave Policies—expanding who was eligible and the amount of the benefit—two states took smaller steps toward supporting family leave.

• • Kentucky will make six weeks of paid leave available to Executive Branch state employees who have serious health conditions or are welcoming a new child through birth, adoption, or foster care. The change will impact about 30,000 employees.
  • South Carolina became the eighth state to authorize optional paid family leave insurance products that employers can purchase to cover paid time off for their employees.

Kinship and related family-centered policies help improve child welfare systems in seven states. 

• • Minnesota, Missouri, and Virginia made it easier for relatives to care for children in foster care. Minnesota’s legislation specifically focuses on addressing racism and disparities in the child welfare system. 
  • Family-strengthening bills in Vermont, Oregon, West Virginia, and Idaho focus on empowering families involved in child welfare, helping families access treatment and community-based services, and strengthening rights and protections. Idaho passed two bills, including the creation of a Foster Care Ombudsman, which creates a grievance process for families to assess and address claims of rights violations in foster care, Idaho was one of just seven states with no agency identified to fill an ombudsman role. The Idaho Legislature also passed a bill that adds restrictions on foster placements in unlicensed group care settings.

Use the map below to see all the progress highlights reported by each state.