Massachusetts Early Childhood State Policy Profile

Overview

The Early Childhood State Policy Profile shows which state policies meet benchmarks that are favorable to the well-being of children and their families. The 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.

A two-generation framework for policy design reflects extensive research that identifies the critical supports young children need over time to thrive. 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.

A brief overview of policies in the EC State Policy Profile is provided below (see policy definitions for an explanation of benchmarks). The Profile is limited to policies for which 50-state data are available. 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.

Health and Development

Related Research and Policy Resources

States can support young children’s development by making key policy choices in early health and development. This section of the Profile highlights states’ policy choices for supporting young children’s well-being: 1) Access to and continuity of health care, including state Medicaid/CHIP eligibility levels and coverage of legal immigrant children; 2) Parents’ access to health care, including for low-income pregnant women, and access to a medical home for young children; and 3) Preventive screening and assessment, including adherence to recommended schedules for well-child visits.

Early Care and Education

Related Research and Policy Resources

States make important decisions about the early care and education services they provide to young children and families. This section of the Profile highlights states’ key policy choices that affect children’s development and parents’ ability to work: 1) Access to childcare, including subsidy eligibility levels and reimbursement rates; and 2) States’ investment in Head Start, Early Head Start, pre-kindergarten, child care centers’ class size and student-teacher ratios and investment in infant/toddler specialist networks and credentials and Quality Rating Improvement Systems.

Parenting and Economic Supports

Related Research and Policy Resources

States make critical policy choices that help low-income parents effectively support young children’s healthy development. This section of the Profile spotlights states’ policy choices related to important economic supports for low-income families with young children: 1) TANF requirements for parents of young children; and 2) Income support policies including tax relief, earned income and dependent care tax credits, as well as child support disregards.

Young children (under age 6)1: 422,035

Percent of children under 6 by income levels, 2022

Source1

Percent of children under 6 by race/ethnicity, 2022

Source1

Percent of children under 6 by family income and race/ethnicity, 2022

Source1

Percent of children under 6 by parents’ immigration status, 2022*

Source1

*If one of the parents is an immigrant, that case is counted under the immigrant group.

Percent of children under 6 by family income and parents’ immigration status, 2022

Source1

Health and Development Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

Sets the income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL)

Children <1 year [2023]2
Sets eligibility at 305% (S-CHIP) and 205% (Medicaid and M-CHIP)

Children 1-5 years [2023]2
Sets eligibility at 305% (S-CHIP) and 155% (M-CHIP and Medicaid)

Children 6-18 years [2023]2
Sets eligibility at 305% (S-CHIP) and 155% (M-CHIP and Medicaid)

Pregnant women [2023]2
Sets eligibility at 205% (Medicaid and Unborn Child Option: CHIP-funded)

Provides lawfully residing immigrant children with Medicaid/CHIP coverage without 5-year waiting period [2023]2

Provides lawfully residing pregnant immigrant women with Medicaid/CHIP coverage without 5-year waiting period [2023]2

Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2021]3

Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2022]4

Provides 12-month continuous eligibility for both Medicaid and CHIP (for child) [2023]5

Provides 12 months of postpartum Medicaid coverage for all eligible women [2024]6
On July 26, 2022, CMS approved Massachusetts' state plan amendment for a 12-month PPC extension for Medicaid.

Extends Medicaid coverage for family planning to otherwise ineligible low-income women [2023]7

Has adopted Medicaid expansion as part of the Affordable Care Act [2023]8

Includes at-risk children in the definition of eligibility for IDEA Part C [2023]9
The relationship between being an at-risk state and the number of children served varies. Some non-at-risk states have higher than average percentages of children being served in Early Intervention (EI). See graphs for the state EI data.

Has an online dual-benefit form to apply for Medicaid and SNAP [2023]2

Requires or recommends maternal depression screening as a part of well-child visits under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit [2023]10
Requires

Has at least one Help Me Grow affiliate site that has fully implemented a centralized access point [2023]11
Massachusetts does not have Help Me Grow.

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics

7 screenings for children <1 year [FY 2021]12
State requires 6 screens. 100% of eligible screens were completed in 2021.

4 screenings for children 1-2 years [FY 2021]12
State requires 4 screens. 100% of eligible screens were completed in 2021.

3 screenings for children 3-5 years [FY 2021]12
State requires 3 screens. 79% of eligible screens were completed in 2021.

4 screenings for children 6-9 years [FY 2021]12
State requires 4 screens. 67% of eligible screens were completed in 2021.

Percent of children under 6 who lack health insurance, 2022

Source1

Percent of uninsured children under 6 by family income, 2022

Source1

Percent of children under 3 receiving Early Intervention services in 2021-2022

Source13

*The following state has missing EI data: Maryland.

Percent of children under 3 receiving Early Intervention services by race/ethnicity in 2021-2022*

Source13

*Notes: 1) EI rates are not displayed where the cell size is small as the data are not reliable. 2) The following state has missing EI data: Maryland.

Percent of eligible children who received at least one EPSDT screening, by age, FY 2021

Source14

Early Care and Education Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

Sets the income eligibility limit for child care subsidies at or above 85% SMI [2022]15

Uses payment rate at or above the 75th percentile of current market rate for center-based care at the highest quality QRIS tier [2022]15
Massachusetts does not have tiered reimbursement rates.

Funds a pre-kindergarten program [2022]16
$57,892,749 in 2022

Supplements Head Start [2022]16
$15,000,000 in 2022

Requires districts to offer full day kindergarten [2023]17
A kindergarten program may be designated as a half-day or full-day program.

Requires one adult for every four 18-month-olds in child care centers [2023]18

Requires one adult for every ten 4-year-olds in child care centers [2023]18

Requires one teacher for every 12 students in kindergarten classrooms [2023]17
Districts must maintain average class sizes of 25 students

Requires that infants and toddlers in child care centers be assigned a consistent primary caregiver [2023]18

Has implemented a statewide Quality Rating Improvement System (QRIS) [2024]19

Has comprehensive, free-standing standards for social emotional learning at the K-12 level [2023]20
Has comprehensive, free-standing standards for SEL, for children in preschool and kindergarten.

Requires a minimum of a bachelor's degree for lead teachers in public pre-K programs and licensed child care centers [2020]21

Monthly child care co-payment fees as a percent of income for a family of three with one child in care, 2022

Source22

National Assessment of Educational Progress (NAEP) fourth grade math and reading scores, 2022

Source23

*Note: NAEP defines proficiency as “solid academic performance for the given grade level and competency… including subject-matter knowledge, application of such knowledge to real-world situations, and analytical skills appropriate to the subject matter.”

Parenting and Economic Supports Policies

50-State Data    Related Research and Policy Resources    Policy Definitions

Exempts single parents on TANF from work requirements until the youngest child reaches age 1 [FY 2022]24
Recipients in the exempt component are automatically exempt from activity requirements. Recipients in the non-exempt component who are caring for a child under 24 months old are exempt from the work requirement.

Reduces the TANF work requirement to 20 hours or less for single parents with children under age 6 [FY 2022]25
Additionaly, recipients with children under age 2 are placed in the exempt component and do not have work requirements. Recipients in the exempt component are not required to participate in work activities.

Allows TANF participants to receive benefits for a maximum of 60 months in their lifetime without limits on continuous coverage [FY 2022]26
Recipients of the exempt and non-exempt groups do not have a lifetime limit. For recipients of the non-exempt group, continuous coverage is limited to 24 months out of 60 months.

Has paid family leave for a minimum of 6 weeks with partial replacement of wages [2023]27
Enacted 2018, effective July 2019 (premiums) and January 2021 (benefits).

Offers accrual of at least five paid sick days [2023]28
Employees can accrue up to 40 hours of unpaid time off in businesses of 1-10 employees and up to 40 hours of paid time off in businesses of 11+ employees.

Established a state minimum wage that meets or exceeds $14.00/hr and is indexed to inflation for a family of three [2024]29
$15.00

Sets gross income eligibility limit at 200% FPL and does not have asset limits for SNAP [2022]30

Does not charge personal income tax for single-parent families of three below the federal poverty level [TY 2022]31

Offers a refundable state dependent care tax credit [TY 2023]32

Offers a refundable state Earned Income Tax Credit [2023]33

Offers a refundable Child Tax Credit [2024]34
Massachusetts offers refundable CTC named Household Dependent Tax Credit. The amount is $180 for one dependent or $360 for 2 or more dependents. "Dependents" are considered children under 12 years old, adults 65 or older, and anyone with a disability. The state also offers a refundable Dependent Care Tax Credit for expenses, but taxpayers can only choose one.

Keeps copayments for child care subsidies at or below 7% of family income for families of three at 150% FPL [2022]15
Exempt from copayments.

Offers exemptions and/or extensions of the TANF benefit time limit for recipients who are pregnant [FY 2022]35
Time limit exemptions are offered if the head of the household is pregnant and the child is expected to be born within 120 days are placed in this component (i.e., month 6 or later of pregnancy). Recipients in the exempt component are exempt from time limits.

Offers exemptions and/or extensions of the TANF benefit time limit for recipients caring for a child under 6 months of age [FY 2022]24
Time limit exemptions are offered if the recipient is caring for a child under age 24 months who is in the unit. Recipients in the exempt component are exempt from time limits.

Offers a minimum of 28 weeks of Unemployment Insurance benefits [2024]36
State provides up to 26 weeks of regular state-funded UI.

Funds a housing program that provides rental assistance to low-income families with children at 80% AMI/200% FPL or less to avoid eviction or homelessness [2024]37
Offers Massachusetts Rental Voucher Program (MRVP) at 80% AMI or less and HomeBASE based on other income eligbility criteria.

Percent of low-income children under 6 by parents’ employment status, 2022

Source1

Education levels of mothers with children under 6, 2022

Source1

Maximum annual TANF benefit for a family of three, for FY 2022

Source38

Percent of low-income families with children under 5 that receive SNAP, 2022*

Source1

*Because the available data only allow setting the low-income threshold at 185% FPL, low-income families in this graph include those with annual income below 185% FPL.

Percent of children under 6 living in families that experience housing insecurity, 2022*

Source1

*A child’s family experiences housing insecurity when their rents or owner costs (e.g., mortgage payments) exceed 30% of the family income on a monthly basis.

Data Notes and Sources

  1. State data were calculated from the 2018-2022 American Community Survey, representing information from the years 2018 to 2022. National data were calculated from the 2022 American Community Survey, representing information from 2022.
  2. Brooks, T., Gardner, A., Yee, P., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2023). Medicaid and CHIP eligibility, enrollment, and renewal policies as states prepare for the unwinding of the pandemic-era continuous enrollment provision. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. Retrieved June 5, 2023, from https://files.kff.org
  3. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2021). Presumptive eligibility. Retrieved July 14, 2022, from https://www.medicaid.gov
  4. Brooks, T., Gardner, A., Osorio, A., Tolbert, J., Corallo, B., Ammula, M., & Moreno, S. (2022). Medicaid and CHIP eligibility and enrollment policies as of January 2022: Findings from a 50-state survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. Retrieved Feburary 8, 2023, from https://files.kff.org
  5. KFF. (2023). State health facts. State adoption of 12-month continuous eligibility for children's Medicaid and CHIP. Retrieved July 17, 2023, from https://www.kff.org
  6. Kaiser Family Foundation. (2024). Medicaid postpartum coverage extension tracker. Retrieved March 8, 2024, from https://www.kff.org
  7. Guttmacher Institute. (2023). Medicaid family planning eligibility expansions. Retrieved September 26, 2023, from https://www.guttmacher.org
  8. Kaiser Commission on Medicaid and the Uninsured. (2023). Status of state action on the Medicaid expansion decision. Retrieved July 17, 2023, from https://www.kff.org
  9. The Early Childhood Technical Assistance Center. (n.d.). State and jurisdictional eligibility definitions for infants and toddlers with disabilities under IDEA Part C. Retrieved February 15, 2023, from https://ectacenter.org
  10. National Academy for State Health Policy. (2023). Medicaid policies for maternal depression screening (MDS) during well-child visits, by state. Retrieved July 17, 2023, from https://nashp.org NCCP reviewed state policies for AR, FL, KS, NE, and NH as of April 10, 2024.
  11. Help Me Grow National Center. (2023). Help Me Grow network affiliates. https://helpmegrownational.org Email correspondences from Melissa Miller on July 31, 2023.
  12. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2021). The annual EPSDT report (Form CMS-416) for FY 2021. Retrieved May 23, 2023, from https://www.medicaid.gov
  13. Early Intervention (EI) rates were calculated by using data from three sources: 2021-2022 EI cumulative counts collected by the US Department of Education, 2018-2022 American Community Survey data, and the 2021-2022 American Community Survey data. EI rates are not displayed where cell size for the numerator (number of children in EI) is missing, or cell size for the denominator (total number of children) is less than 200. To access EI data, please go to IDEA Section 618 Data Products: Table 11 Cumulative count of infants and toddlers birth through age 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state 2021-2022. https://data.ed.gov . To access ACS data, please visit the US Census Bureau data tool. https://data.census.gov
  14. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2022). The annual EPSDT report (Form CMS-416) for FY 2021. Retrieved June 7, 2023, from https://www.medicaid.gov
  15. Schulman, K. (2023). Precarious progress: State child care assistance policies 2022. National Women's Law Center. Retrieved June 13, 2023, from https://nwlc.org
  16. Friedman-Krauss, A. H., Barnett, W. S., Hodges, K. S., Garver, K. A., Weisenfeld, G. G., Gardiner, B.A., & Jost, T. M. (2023). The state of preschool 2022: State preschool yearbook. National Institute for Early Education Research. Retrieved August 24, 2023, from https://nieer.org
  17. Education Commission of the States. (2023). State education policy tracking. Retrieved August 24, 2023, from https://www.ecs.org NCCP also referenced ECS's 2023 50-State Comparison: State Kindergarten-Through-Third-Grade Policies. https://reports.ecs.org
  18. NCCP's review of state child care licensing regulations as of August 23, 2023. Policies were retrieved from the National Database of Child Care Licensing Regulations. https://childcareta.acf.hhs.gov
  19. The Quality Compendium. (2024). Individual state profiles. The BUILD Initiative. Retrieved March 5, 2024, from https://qualitycompendium.org
  20. Collaborative for Academic, Social, and Emotional Learning (CASEL). (2023). Social-emotional learning policy at the state level. Retrieved July 31, 2023, from https://casel.org
  21. McLean, C., Austin, L.J.E., Whitebook, M., & Olson, K.L. (2021). Early childhood workforce index 2020. Center for the Study of Child Care Employment, University of California, Berkeley. Retrieved March 10, 2021, from https://cscce.berkeley.edu
  22. Schulman, K. (2023). Precarious progress: State child care assistance policies 2022. National Women's Law Center. Retrieved June 11, 2023, from https://nwlc.org
  23. U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. (2022). National assessment of educational progress (NAEP): 2022 Math and reading assessment. Retrieved January 24, 2022, from https://nces.ed.gov
  24. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov
  25. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov NCCP reviewed state policies for OR and WI as of March 27, 2024.
  26. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov NCCP reviewed state policies for AR, CT, IN, NM, and NY as of April 10, 2024.
  27. National Partnership for Women & Families. (2023). State paid family and medical leave insurance laws. Retrieved March 20, 2024, from https://www.nationalpartnership.org
  28. National Partnership for Women & Families. (2023). Paid sick days - State and district statutes. Retrieved March 14, 2024, from https://nationalpartnership.org
  29. National Conference of State Legislatures. (2024). State minimum wages. Retrieved March 5, 2024, from http://www.ncsl.org
  30. Aussenberg, R.A., & Falk, G. (2022). The Supplemental Nutrition Assistance Program (SNAP): Categorical eligibility. Congressional Research Service. Retrieved August 28, 2023, from https://crsreports.congress.gov
  31. NCCP's calculations derived from output generated by the National Bureau of Economic Research Internet TAXSIM Version 35, available at https://taxsim.nber.org for the 2022 tax year. For a description of the TAXSIM model, see Feenberg, D. and Coutts, E. (1993). An Introduction to the TAXSIM Model. Journal of Policy Analysis and Management 12(1): 189-194.
  32. National Women's Law Center. (2024). States can make care less taxing, Tax year 2023. Retrieved February 27, 2024, from https://nwlc.org
  33. Urban Institute. (2023). State earned income tax credits. Retrieved August 24, 2023, from https://www.urban.org NCCP also referenced the Tax Policy Center's State EITC as percentage of the federal EITC. Retrieved August 24, 2023, from https://www.taxpolicycenter.org
  34. National Conference of State Legislatures. (2024). Child tax credit overview. Retrieved March 13, 2024, from https://www.ncsl.org
  35. Knowles, S., Dehry, I., Shantz, K., & Giannarell, L. (2023). Welfare rules databook: State TANF policies as of July 2022. OPRE Report 2023-327. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. https://www.acf.hhs.gov NCCP reviewed state policies for SC as of March 27, 2024.
  36. Center on Budget and Policy Priorities. (2024). Policy basics: How many weeks of unemployment compensation are available? Retrieved April 5, 2024, from https://www.cbpp.org
  37. NCCP reviewed state funded rental housing programs as of April 16, 2024. Programs were retrieved from the National Low Income Housing Coalition Database. https://nlihc.org
  38. Thompson, G. T., Azevedo-McCaffrey, D., & Carr, D. (2023). Increases in TANF cash benefit levels are critical to help families meet rising costs. Retrieved March 1, 2023, from https://www.cbpp.org

Last updated on May 1, 2024