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North Carolina

The Alliance’s lead ally in North Carolina, NC Child, advances effective, data-driven policy solutions for a strong start in life, healthy children, safe and nurturing homes and communities, family economic security, and high-quality education. They provide research and data analysis, educate policy makers, engage the community, do media engagement and strategic communications, and coordinate the Child Advocacy Network.

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2022 State Early Childhood Policy Environment and Progress

State early childhood policy progress is dependent both on the state’s policy environment and the numerous efforts — by those listed on this page and many others — who worked both independently and collaboratively to achieve wins for young children.

Policy Landscape:

State General Fund Appropriations: Growing 

After budget adjustments signed into law for fiscal 2023, general fund spending totals $27.9 billion, an increase of 3.4 percent, or $921.5 million, over the original amount enacted in November 2021. The prior fiscal 2023 general fund certified revenue amount was $28.8 billion, and the Consensus Revenue Forecast May Revision increased that to $30.7 billion, an increase of 6.8 percent. The state is projected to have a beginning unreserved general fund balance for fiscal 2023 of $6.5 billion and an unappropriated balance of $25.2 million at the close of the fiscal year. A total of $7.7 billion is set aside in reserves, including $1.0 billion in a new Stabilization and Inflation Reserve.1

Political Alignment: Divided

During the session, the state’s Senate and House were both Republican controlled. The state’s Governor was a Democrat.2

Young Children in Low-Income Households: Declining

Approximately 45% (490,000) of the state’s children 0-8 live in households below 200% FPL. This number represents a decrease from 52% (574,000) in 2015.3

Racial Disparity Among Young Children Living in Low-Income Households: High

Non-White children 0-8 are significantly more likely to be living in households below 200% FPL.3

Advocacy Landscape:

Key state policy advocacy organizations include:

Early childhood policy advocacy multi-state initiatives present in the state include4:

2022 Policy Progress:

North Carolina’s 2022 legislative “Short Session” packed lots of legislative action into a very short timeframe. We are very proud to report that the legislature enacted several important policy changes that will make children’s lives better in our state.  However, there are still many more opportunities to invest in the needs of young children and families – notably family economic security, mental health, and early childhood education. We will continue to push for meaningful investments in these priorities.

Highlights from the state’s early childhood policy advocacy community include5:

From the budget bill:

Merging the NC Health Choice program (also known as CHIP) with NC Medicaid. After more than two decades of advocacy, this policy change was included in the 2022 budget bill. This will reduce administrative duplication, and ensure continuous, quality coverage for more than 100,000 NC children – particularly those with special health care needs.

Improving child care subsidy reimbursement rates. Legislators did temporarily increase the reimbursement rates to the 2018 market rate survey county rates (the most recent survey available) in the 2022 budget bill via a reallocation of federal ARPA relief funds. However, advocates are still pushing for the creation of a statewide rate floor for child care subsidy, which would more equitably support providers across the state, particularly in rural counties.

Increasing NC Pre-K rates. Legislators appropriated an additional $9M in recurring funds in the budget to increase the NC Pre-K rate by 7% in FY 2023, for a total rate increase of 9% since the 2020-21 fiscal year. The appropriation intends to support NC Pre-K teacher salaries in private program settings and also includes funds specifically designated to support NC Pre-K classrooms in public school and Head Start settings.

North Carolina has yet to close the coverage gap by expanding the NC Medicaid program. Medicaid expansion would bring affordable, quality health care access to approximately 500,000 residents—at least 1/4 of whom are parents with children at home. However for the first time ever, both the House and the Senate passed Medicaid expansion bills during the 2022 session. The two chambers have not yet found a way to reconcile differences but advocates remain hopeful that Medicaid expansion is in North Carolina’s future.


North Carolina Advocacy Snapshot:

North Carolina Allies Center Lived Experience and Racial Equity to Strengthen the Early Childhood Social-Emotional Health System

Advocates at NC Child partnered with the NC Early Childhood Foundation to launch the EarlyWell Initiative in 2019 to lead the implementation of recommendations from the Pathways to Grade-Level Reading Action Framework. The EarlyWell initiative is informed by the voices of parents and caregivers to ensure that system best reflects the needs and lived experiences of North Carolina communities.

Read More »


National Association of State Budget Officers, Summaries of Fiscal Year 2023 Enacted Budgets, September 20, 2022.

National Conference of State Legislatures, 2021 State & Legislative Partisan Composition, February 2, 2022.

Kids Count Data Center, Annie E. Casey Foundation, Children Ages 0 to 8 Below 200 Percent Poverty, December, 2020; NCCP Analysis of ACS 5-Year Estimates – Public Use Microdata Sample 2016-2020.

Alliance for Early Success, Multi-State Initiatives for Early Childhood Policy Advocacy, April, 2022.

Alliance for Early Success, State-Wide Advocacy Highlights Survey, April-September, 2022.  

2023 Grantee Policy Agenda:

The Alliance’s lead grantee in North Carolina, NC Child, is working to advance early childhood policies in several areas: 

Early Care and Education

Child Care

Child Care Workforce

Preschool and Pre-K


Child and
Maternal Health

Maternal Health

Infant & Child Health



More State Policy Data:

North Carolina
North Carolina
North Carolina

More State Demographic Data:

North Carolina
North Carolina