Advocates in Massachusetts say increasing the pay of smaller, family child care providers could help ease the shortage and provide economic benefits statewide.

The majority of providers work overtime at less than the state's $15 minimum wage, providing licensed care for up to 10 children in their homes.

Adam Jones, policy analyst at the Massachusetts Budget and Policy Center, said providers offer a smaller portion of child care slots statewide but serve some of its most vulnerable children.

"Clearly, they're not the majority of slots," Jones acknowledged. "But a fifth is a lot and I think, as the pandemic showed us, every slot matters."

Jones pointed out pending legislation would codify child care grants into state budgets to stabilize funding and increase reimbursement rates to help provide a living wage for providers and quality care for children.

Research shows the child care crisis in Massachusetts is hurting both families and the overall economy. More than 10% of children younger than age six lived in families in which someone quit, changed, or refused a job because of problems finding care in the past few years.

Jones noted family child care centers give parents more options and offer economic mobility to the many female -- often minority -- business owners who run them.

"By providing more support, these can become businesses that thrive," Jones contended. "They definitely have the potential to be that, even if they aren't quite that right now."

Massachusetts gets high marks in health care and education but the benefits are not experienced equally.

Jones added providing greater state support to family child care providers centers racial and economic equity in early education expansion.

Ohio's child care system is under strain and a new national report highlighted how Medicaid helps support the workforce behind early childhood care, especially in rural communities.

Medicaid provides critical coverage for child care providers, many of whom are low-paid and often go without employer-based insurance.

Brittany Boulton, vice president of the policy and advocacy organization Groundwork Ohio, said it is especially vital for rural families.

"Cuts to Medicaid would make these problems far worse and leave thousands of Ohioans and rural families without access to coverage and care," Boulton pointed out.

A report by the Georgetown University Center on Children and Family Studies said 30% of children in rural Ohio rely on Medicaid for health coverage, placing the state among the top 10 nationally for rural child enrollment.

National experts warned access to health care is essential not only for children but also for those who care for them.

Daniel Hains, chief policy and professional advancement officer for the National Association for the Education of Young Children, said there is a clear link between health coverage and workforce stability. He noted about 16% of early educators lack insurance and those who do have coverage are more likely to stay in the field.

"We need more highly qualified, well-supported, well compensated early childhood educators, with 25+ percent of early childhood educators relying on Medicaid for their own health insurance," Hains noted. "With the critical supports the program provides for their education and for the children and families they serve."

Ohio's child care sector has lost nearly 6,000 workers since the pandemic began and Groundwork Ohio said access to Medicaid helps retain educators in a field facing critical staffing shortages.

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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