CHARLESTON, W. Va. - New research has found that West Virginia's expansion of Medicaid has brought huge health improvements for pregnant women and their babies.

In 2013, according to the report from Georgetown University's Center for Children and Families, nearly one out of four women of childbearing age in the state lacked insurance. Now that number has fallen by more than two thirds.

Sharon Carte, board president for West Virginians for Affordable Health Care, said expansion has meant a huge decline in infant deaths, here and around the country.

"According to this report, the states that have adopted an expansion have seen drops in their infant mortality rate," she said, "reductions that are 50% greater than those states that did not adopt it. That's a really big deal."

The report, available on the center's website, was released in conjunction with the March of Dimes and the American College of Obstetricians and Gynecologists.

One serious and surprising issue for U.S. health care has been an unexpected rise in the number of women dying in childbirth. However, Joan Alker, the Georgetown Center's executive director, states that are getting women into the Medicaid system actually are reducing maternal mortality rates. She said it's the best way to address what she called a crisis.

"We are really the only very developed country that's seeing that, and that's very troubling," she said. "For states that have not expanded Medicaid, Medicaid expansion is clearly the single most important step a state could take to address this crisis."

According to West Virginians for Affordable Health Care, expansion also has proven to be good for getting pregnant women who are addicted to drugs into the substance-abuse treatment they need. The group has said that's better both for the women and their children.

The Georgetown report is online at ccf.georgetown.edu.

A refundable child tax credit aimed at helping families with young children was proposed in Gov. DeWine's budget but was stripped out by the Ohio House.

Advocates said it is not too late for lawmakers to restore it and offer families some financial relief.

Lynanne Gutierrez, president and CEO of the advocacy group Groundwork Ohio, said the funding is critical.

"This is a really strong policy that acknowledges the needs of families," Gutierrez explained. "It won't solve everything but it is an almost billion dollar investment. So his largest, single largest investment in young children and families that has been proposed in his tenure."

If passed, the child tax credit would be Ohio's largest direct state investment in young children to date, providing up to $1,000 per child under age seven, at a time when more than eight in 10 Ohio parents said inflation is forcing them to cut back on groceries.

Opponents argued the state cannot afford it but polling by Public Opinion Strategies showed nearly five of six Ohio voters support a state child tax credit, including majorities across party lines, with more than four of five Republicans, nearly eight in 10 independents, and almost 95% of Democrats. Support grew even higher when respondents learned it had been supported by both Presidents Biden and Trump.

Guillermo Bervejillo, research manager for the Children's Defense Fund of Ohio, called it a bipartisan policy.

"Nearly 20% of children in Ohio are living in poverty currently," Bervejillo pointed out. "That's 470,000 kids. A refundable child tax credit would have directly put money into the hands of those most in need and who are taking care of children."

Supporters said the Senate now has a chance to restore it in the final budget version, due by July 1. They are encouraging families to contact legislators, write letters or attend a rally June 17 at the Statehouse in support of the credit.

The lack of quality child care for infants and toddlers costs Colorado nearly $3 billion each year in lost earnings, productivity and revenue but an initiative in Mesa County shows what is possible when local governments, businesses and civic groups team up.

Keller Anne Ruble, client success manager for the software firm BridgeCare, said officials saw huge demand for child care in the town of Clifton, but no providers. So they built a new facility that provides child care and also trains new caregivers.

"So that they can meet the needs of working families and invest in their early care workforce pipeline," Ruble explained. "And because of that investment, they now have 270 seats at this child care center, and they've completely eliminated their child care desert."

Budgetary constraints imposed by Colorado's Taxpayer Bill of Rights make it much harder for the state to invest tax revenues in initiatives such as the one in Clifton. The state also recently froze enrollment in the Colorado Child Care Assistance Program. Over the past 15 years, Colorado's economic growth has dropped from fifth in the nation to 41st, according to the 2025 Colorado University Leeds School of Business report.

Half of Colorado parents said they have quit jobs, worked fewer hours and taken unpaid time off. In 2023, more than 10,000 moms left the workforce, all because of a lack of child care.

Ruble emphasized when the cost of child care is too high, many parents just cannot afford to go to work.

"Families across the country are spending up to 60% of their income on child care," Ruble pointed out. "That's equivalent to a second mortgage or a second rent payment."

Children younger than age 3 are experiencing one of the most crucial periods of brain development and Ruble stressed investing in quality care is important for their long-term health.

"When young children have high-quality, enriching early experiences with trusted caregivers, it sets them on a strong foundation for growing, flourishing into thriving adults that contribute to our workforce and our society," Ruble asserted.


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The number of Kentucky children enrolled in preschool increased in 2024, along with state spending per child, according to new data from the National Institute for Early Education Research.

The commonwealth spent around $6,500 per child during the last academic year, an increase of more than $800 from the prior year.

Steve Barnett, founder and senior director of the institute and the study's co-author, said it is unrealistic to think states could replace cuts to Head Start funding amid the Trump administration's proposed freezes of federal grant funding.

"And particularly replace it overnight if the program is suddenly defunded," Barnett emphasized. "States are going to have to step up and figure out what to do if that happens."

He added if Head Start funding is eliminated, access to public preschool will decline in several states by more than 10 percentage points, and in some, by 20.

Kentucky lawmakers have taken recent steps to expand preschool access, including passing House Bill 695, which established the Adaptive Kindergarten Readiness Pilot Project. The measure aims to provide no-cost, online education for 3- and 4-year-olds who may not be attending state-funded preschool programs.

Allison Friedman-Krauss, associate research professor at the institute, said states spent more than $13 billion on preschool last year, including $257 million in federal pandemic relief funding, in part to attract more qualified teachers.

"We also see in our data that many states are reporting teacher shortages in early childhood, that they've had to increase their waivers in order to get teachers in classrooms," Friedman-Krauss reported.

Research shows toddlers who attend preschool are more prepared for elementary school and less likely to be identified as having special needs, or be held back, than children who do not.


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