Welcome to Legislative Trends, your go-to source for the latest updates on state policy action affecting infants, toddlers, and their families during legislative sessions. Each week, our team of policy analysts tracks key legislative movements, from state budget proposals impacting Medicaid and SNAP to bills advancing paid family leave, child care, and other critical prenatal-to-3 policies. Below is a sampling of legislation we’re tracking from across the country, all grounded in the evidence-based policies highlighted in our Prenatal-to-3 Policy Roadmap. Stay informed and ahead of the curve with our timely analysis of the trends shaping early childhood policy. 

KEY HIGHLIGHTS

• Doulas: States continue to introduce and advance bills to support community-based doulas through Medicaid and private insurance coverage. 
• Medicaid: States passed bills requiring legislative approval for changes to Medicaid programs.  
• Tax Credits: States continue to propose legislation to implement and modify tax credits for families.

LEGISLATIVE UPDATES

Administrative Burden

• Texas H.B. 5160, which would extend SNAP certification periods for all families to 12 months and require the state annually update asset limits to adjust for inflation.   
• Louisiana S.B. 14, which would prohibit SNAP recipients from purchasing soft drinks with their SNAP benefits as a part of a larger package requiring additional nutrition disclosures and education. 
•  Alabama S.B. 246, which would prohibit the use of categorical eligibility in the state's SNAP program. 

Doulas

• Texas H.B. 5583, which would require Medicaid coverage of doula services effective September 1, 2025, and requires implementation of the benefit by October 1, 2026.  
• New York S.6494, which would add doula services to maternity care currently covered by private insurance providers, effective 180 days after passage.  
• Arkansas H.B. 1252, which directs the Department of Health to oversee community-based doula certification and registry and directs the Department of Human Services to enact rules to reimburse doulas through Medicaid. Covered services include four prenatal appointments, two postpartum visits, 14 hours of care during a hospital birth, and 50 hours of postpartum support. Rules must be in effect for the Medicaid benefit by December 31, 2025. The bill passed the House and is in the Senate.  
• New Mexico H.B. 214, which directs the Secretary of Health to create rules for voluntary doula certification in the state to facilitate enrollment as Medicaid providers, passed the Senate (the bill previously passed the House). The bill also creates the doula credentialing advisory council and starts the doula fund in the state treasury. 

Early Intervention

• Florida S.B.112, which would expand Early Steps services and support for children with developmental disabilities, especially children with autism spectrum disorder, passed the Senate. 

Home Visiting

• Texas H.B. 5152, which would require Medicaid reimbursement for evidence-based home visiting programs provided through Texas' nurse home visiting program.  
• Nebraska L.B. 22, which proposes adding the state's home visiting program to statute with a requirement for evidence-based programs, has advanced to its final reading. The bill also directs the Department of Health and Human Services to pursue a Medicaid state plan amendment to cover home visiting services for children under six months old. 

Medicaid

• Idaho H.B. 345, which would mandate that the Department of Health and Welfare receive legislative approval before seeking Medicaid state plan amendments or waivers that expand coverage or increase net costs to the state, passed both chambers and was sent to the Governor. The bill also requires the state to seek a waiver for work requirements. The bill includes other changes to the Medicaid system, such as moving the state Medicaid system to managed care.  
• Kentucky H.B. 695, which would require the Cabinet for Health and Family Services receive authorization from the legislature before making any changes to Medicaid eligibility, coverage, benefits, or reimbursement rates, passed both chambers and was sent to the Governor. The bill also requires the Cabinet to submit detailed fiscal impacts to the legislature before submitting any new waivers or renewing waivers. 

Paid Family and Medical Leave

• Rhode Island H.B. 6066, which would increase the PFML program wage replacement rate to 85% of wages, increase the amount of a worker's wages subject to the PFML premium, and create an opt-in option for self-employed workers.  
• Texas H.B. 5326, which would create a statewide PFML program providing up to 12 weeks of leave.

State Minimum Wage

• North Carolina H. 403, which would eliminate the subminimum wage for tipped workers and would repeal the state's preemption law prohibiting localities from adopting a minimum wage higher than the state minimum wage.  

Tax Credits

• Oregon S.B. 121, which would extend the sunset date for Oregon's earned income tax credit from TY 2026 to 2032, was heard in committee. 
• Iowa H.F. 962, which would revise the state's existing refundable child and dependent care tax credit (CDCTC) by removing top income eligibility brackets to make families with incomes above $25,000 eligible for a credit worth 50% of the federal CDCTC.  
• Rhode Island H.B. 6072, which would create a refundable child tax credit (CTC) equal to $1,000 per eligible child under age 18.

Thank you for staying up to date with this week’s legislative updates. Our team is dedicated to monitoring the policies and trends that impact the prenatal-to-3 space and beyond. For deeper insights into the evidence-based policies driving early childhood progress, explore our Prenatal-to-3 Policy Roadmap. If you have any questions or have an important update from your state, please contact Alyssa Rafa, Assistant Policy Director, at alyssa.rafa@vanderbilt.edu. Let’s work together to drive lasting progress for young children and their families.

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Prenatal-to-3 Policy Impact Center