Many states expanded care for children, older adults and workers
Jul 31, 2026 | 12:37 pm ET
Description
A new report found that in the past two years, more than half the states expanded care for children and services for older adults and disabled people. But they will be hard-pressed to maintain funding in the face of federal cuts. (Photo by Nuria Martinez-Keel/Oklahoma Voice)
Many states have made marked progress over the past two years in extending crucial care and benefits to children, workers and aging adults. But they will be hard-pressed to fill the void left by impending federal cuts to social services, according to a new analysis.
A report released this week by The Century Foundation and Caring Across Generations found that more than half the states improved services for children, older adults and disabled people and made family and medical leave more available for workers.
The report ranks states on both their overall performance in those areas and highlights progress since the nonprofit groups began to grade the states in 2021. It gave top grades to California, Oregon, New York, Massachusetts and New Jersey. The lowest rankings went to Alabama, Mississippi, Wyoming, Florida and North Carolina.
But federal policy changes will have a major impact on state budgets, the authors note.
The broad tax and spending measure that President Donald Trump signed last summer imposed major cuts and eligibility changes to Medicaid, the public health insurance program for low-income people, and to the Supplemental Nutritional Assistance Program (SNAP), commonly known as food stamps. Additionally, Congress allowed federal subsidies for Obamacare health care plans to expire at the end of last year, pushing millions off the program.
The report says cuts to Medicaid, Obamacare and the food stamp program “have left state budgets with constraints that will be difficult, if not impossible, to overcome.”
The report called out five states that saw the most improvement since the last evaluation in 2024: Virginia, New York, Nebraska, Michigan and Washington.
While the liberal-leaning groups gave their top marks mainly to Democratic-led states, they did highlight incremental progress in conservative Southern states. In particular, the study highlighted efforts to expand paid leave for state employees in Alabama, Georgia, Mississippi and Tennessee.
Stateline reporter Kevin Hardy can be reached at [email protected].
