2023 State Legislative Trends Across the Prenatal-to-3 System of Care

By Alyssa Rafa, Policy Manager 

In addition to conducting research and evaluating evidence, at the Prenatal-to-3 Policy Impact Center, we also track state legislation and administrative action impacting young children and their families. These efforts provide us with context to update state-level action on the most effective policies and strategies we have identified for our Roadmap. This blog post is the first in a series of legislative updates that will provide an overview of the real-time trends we are seeing. 

Emerging trends in 2023 include supporting the child care workforce, incentivizing employer-supported child care, extending Medicaid through the postpartum period, creating paid family leave programs, and increasing earned income tax credits. What follows is a sample of legislative action in states throughout the country. 

Child Care Workforce Supports and Employer-Supported Care Incentives 

Addressing the child care crisis continues to be an area of bipartisan interest for state policymakers. Proposals are making their way through state legislatures across the country—with trends in bills that are intended to bolster the child care workforce and incentivize employers to support the child care needs of their employees. 

  • Hawaii: S.B. 312 would address workforce concerns by creating a pilot program to increase the minimum compensation for child care workers in licensed infant and toddler classrooms to $16/hour.

  • Washington: Addressing workforce compensation from a somewhat different angle, S.B. 5225 would expand eligibility for child care subsidies and waive copayments for child care workers with incomes up to 85% of the state’s median income.

  • North Dakota: S.B. 2301 would support the workforce by sending additional monthly payments to licensed child care providers, with the requirement that those funds are used to address the wages and benefits of child care workers.

Incentives for employers to support their employees’ child care needs have not only become more prevalent on a federal level, but are also taking hold in state legislatures: 

  • Pennsylvania: S.B. 252 offers a tax credit for employers that either provide child care services directly or reimburse employees for any portion of their child care costs.

  • Massachusetts: H.D. 3732 would support employers in offering or expanding child care options as a benefit to their employees using funds from the state Early Education and Care Private-Public Partnership Trust Fund. The bill would also create a special commission to study and make recommendations on employer-supported child care benefits.

  • New York: A 3009/S 4009 would provide employers with a tax credit for creating or expanding access to child care for their employees, either directly or through a third party.

Medicaid Expansion and Postpartum Extension 

To date, 11 states have not increased access to health insurance coverage by expanding Medicaid eligibility. Several of those states brought this issue to the fore in 2022, and that trend has continued in 2023—with mixed results.  

  • North Carolina: The Tarheel state has made significant progress toward expanding Medicaid this session, as H.B. 76 passed the House and is currently being considered in the Senate. Continued progress looks promising, with leaders in both chambers recently announcing that they have reached a deal on the program and expect to send the bill to the Governor’s desk.

  • Wyoming and Mississippi: Both states advanced Medicaid expansion bills that were halted in the legislative process. Though these broad Medicaid expansion efforts dwindled, a hopeful trend has emerged in these same states in the form of postpartum extension for Medicaid—which provides eligible mothers with Medicaid coverage for 12 months after the birth of a child. Wyoming’s H.B. 4 was recently signed into law by Governor Mark Gordon after clearing several legislative hurdles by a narrow margin. In Mississippi, S.B. 2212 passed both the Senate and the House and is anticipated to become law, as Governor Tate Reeves has announced support for postpartum extension, indicating that he would sign the bill upon its passage.

Paid Family Leave and Earned Income Tax Credit Momentum 

Last year, 23 states introduced legislation to adopt a statewide paid family leave program of at least 6 weeks, and two states (Delaware and Maryland) ended up enacting their respective bills. So far this session, both Minnesota and New Mexico are showing significant momentum on their paid family leave bills.  

  • Minnesota: Companion bills S.F. 2/H.F. 2 would create a statewide paid family leave program of up to 12 weeks for eligible workers. The bills have been advancing through legislative committees. Eligible workers would receive up to 90% of their average weekly wage; workers with lower incomes would receive a higher percentage of their income, and workers with higher incomes would receive a lower percentage of their income.

  • New Mexico: On the heels of a task force report with recommendations on adopting and implementing a statewide paid family leave program, the New Mexico legislature introduced S.B. 11, which would create a statewide paid family leave program of up to 12 weeks for eligible workers. Workers earning the state minimum wage ($12.00/hour) would receive 100% of their wages, and workers earning more than the minimum wage would receive 67% of their wages while on leave. The bill has passed in the Senate and is currently being considered in the House.

Each year, several states consider legislation to adopt new or expand existing state earned income tax credits (EITC) as a means of lifting families out of poverty. So far in 2023, efforts in Michigan and Montana are proving to be promising.  

  • Michigan: H.B. 4001 was recently signed into law by Governor Gretchen Whitmer. The law will increase the state’s already refundable EITC from 6% to 30% of the federal credit, a change which meets our threshold of evidence for the 2023 Roadmap!

  • Montana: Governor Greg Gianforte’s proposed budget includes an increase to the state’s refundable EITC from 3% to 10% of the federal credit. Just this week, legislative efforts aiming to make the same increase to the state EITC proved successful, as the Governor signed S.B. 121 into law.

We will continue to post state policy updates on our blog throughout the heavy legislative season. Our team of over 30 researchers, policy experts, data analysts, and communicators is closely tracking state action in early care and learning, child and parent health, and economic and family supports. Be sure to follow us on social media and sign up for our newsletter