In the 250th year of the United States, how the country raises its next generation matters as much as any of the questions on the national agenda. This report — the first to score all 50 states and the country's 250 largest cities on a single composite of access, affordability, workforce, family strain, and public investment — finds that the system most American families now navigate has stopped working as advertised.
A year of infant care in the United States now costs $17,163 — about a thousand dollars more than the median American renter pays in rent, and more than in-state college tuition in 38 states. The worker minding that infant earns $15.41 an hour, a wage so low that 43 percent of early educator households draw on public assistance to stay solvent. Between those two numbers sits a market that no longer clears. Families ration care, providers ration slots, and the bill arrives elsewhere: $172 billion a year in lost parent earnings and business productivity, the steepest six-month drop in mothers' labor force participation since 1984, and a fertility rate that has fallen to 1.626 — the lowest the country has ever recorded. Of 250 cities scored across affordability, supply, workforce, family strain, and policy, none cleared 80; Pearland, Texas led at 74, Sunrise Manor, Nevada came last at 14, and most of the country sits closer to Sunrise Manor than to Pearland. What follows is an audit of how the math broke, who is paying for it, and where the pressure is sharpest.
Key highlights & actionable takeaways
The findings
- $172 billion lost annually in parent earnings and business productivity; families pay $17,163 for infant center care while the workers providing it earn $15.41 an hour.
- Mothers of children under 5 dropped out of the workforce 2.8 points in six months — January to June 2025 — the sharpest reversal since 1984; fertility hit an all-time low of 1.626.
- None of 250 cities scored above 80: Pearland, Texas topped the index at 74, Sunrise Manor, Nevada came last at 14, and only North Dakota cleared 70 among states.
What to take from the data
- Policy alone does not win. Four of the five most policy-rich states (NY, MA, NJ, MD) finished Strained. Public pre-K, paid leave, and CCDF investments cannot offset an under-3 cost crisis they do not address. The next wave of childcare policy that matters is the one that intervenes on infant-and-toddler tuition.
- The top of the ranking is private income, not public design. Every one of the ten highest-scoring cities is an affluent suburb of a major metro — Pearland, McKinney, Frisco, Plano, Sugar Land, Jersey City, Fremont, Coral Springs, Port St. Lucie, Lubbock. The replicable lessons are in the second tier: Lexington (#11), Cedar Rapids (#19), Buffalo (Workforce score 96/100), Augusta (#24) — places where balanced systems hold without six-figure household incomes.
- The cleanest single indicator of system sustainability is the childcare worker wage-to-living-wage ratio. Below 60%, providers cannot recruit and retain staff; below 50%, the "cheapness" of care is structurally subsidized by worker poverty. DC clears 80% — the only US geography where childcare workers approach a living wage, and the result of a deliberate public-funding choice. Mississippi sits at 50%. Watch this ratio as a macro signal of provider collapse.
I. The math broke
The price tag for infant care in the United States now averages $17,163 a year — the population-weighted figure across every county for which the Department of Labor publishes data, projected forward from the 2023 National Database of Childcare Prices to 2025 dollars. That is more than the median annual gross rent of $16,176 paid by American renters. Childcare for a single infant costs more than housing in a country where housing is the single biggest household line item.
It is also more than public college tuition. The Economic Policy Institute, updating its state-by-state cost calculator in March 2025, found that an infant in center-based care now costs more than in-state public college tuition in 38 states and the District of Columbia. Child Care Aware of America, using a higher national average price of $13,128 derived from state-level surveys, puts the count at 41. Either way, the headline that a year of daycare costs more than a year of college is no longer rhetorical. It is the median experience in most of the country.
The wage on the other side of that transaction has not moved. The Bureau of Labor Statistics' May 2024 OEWS estimate puts the median hourly wage for childcare workers (SOC 39-9011) at $15.41. The Center for the Study of Child Care Employment, which uses the broader American Community Survey "early educator" definition that includes home-based providers, puts it at $13.07 — a 59 percent gap below the $31.80 median earned by elementary and middle school teachers.
Forty-three percent of early educator households now rely on at least one public assistance program — Medicaid, SNAP, EITC, TANF, CHIP, or WIC — at an annual taxpayer cost of $4.7 billion. Thirteen percent live below the federal poverty line, more than five times the rate among K-8 teachers. CSCCE's 2024 Workforce Index notes that 97 percent of all other US occupations pay better than early childhood education.
"Child care is a textbook example of a broken market, and one reason is that when you pay for it, the price does not account for all the positive things it confers on our society." — Janet Yellen, U.S. Treasury Secretary, September 2021
The cost to the broader economy is now legible in a single line. ReadyNation, the bipartisan business arm of Council for a Strong America, updated its long-running estimate of the national price of childcare scarcity in February 2026: $172 billion a year in lost parent earnings ($134 billion) and business productivity ($38 billion) — an average loss of $6,980 per affected working parent. That figure, which covers children under 5, replaces ReadyNation's earlier $122 billion estimate (under-3 only) from 2023. Whichever lens one uses, the number has roughly tripled since the same group's 2018 baseline of $57 billion.
These two numbers — the price families pay and the wage providers earn — have decoupled. Center-based care charges what an upper-middle-income market can absorb; provider wages reflect what a federally and state-subsidized labor market will tolerate. In between sits a gap that neither side can close on its own.
Dimension spread across the 50 states
Source: Beverly Research, 2026 State of Childcare Index. Worst, median, best state per dimension.
Tier distribution
Source: Beverly Research, 2026 State of Childcare Index.
II. The village is gone
In August 2024, then-Surgeon General Vivek Murthy issued a formal advisory titled "Parents Under Pressure." The headline finding: 48 percent of American parents describe their stress as "completely overwhelming" most days, against 26 percent of other adults. Forty-one percent say they are so stressed they cannot function.
"Something has to change. Raising children is sacred work. It should matter to all of us... The work of raising a child is work, no less valuable than the work performed in a paid job." — Vivek Murthy, U.S. Surgeon General, August 2024
A separate national survey, conducted by Ohio State University Wexner Medical Center in April 2024, found that 66 percent of parents say the demands of parenthood feel isolating and lonely; 62 percent report burnout; 38 percent say they have no one to support them. Seventy-nine percent said they would value a way to connect with other parents — a number that quietly indicts every assumption that grandparents, neighbors, and church basements still backstop American family life. They do not, at least not at the scale they once did.
The cost shows up on payroll. Between 1.2 and 1.5 million American workers each month miss work or work part-time because of childcare problems, according to KPMG's analysis of BLS Current Population Survey microdata. Women account for roughly 90 percent of those workers. Annualized, the country loses 9 to 26 million work-hours per week to a single category of disruption.
The labor force consequences are no longer subtle. Between January and June 2025, the labor force participation rate for mothers ages 25-44 with children under 5 fell from 69.7 percent to 66.9 percent — a 2.8-point drop in six months, the steepest such decline since at least 1984. Black mothers' LFP has fallen 2.8 percentage points since December 2023, twice the average rate. The University of Kansas Care Board, which assembled the BLS LAUS data, called it "the sharpest reversal of mothers' workforce gains in 40 years."
This is not a story about preference. The American Community Survey shows that 67.7 percent of children under 6 — about 14.4 million — live in households where every available parent is in the workforce. The infrastructure those families depend on has shrunk. Parents who cannot find care leave jobs, reduce hours, or reorganize their entire week around the gap. The "village" that Murthy and Ohio State both reach for as shorthand was always partly metaphor; what is new is how visibly the metaphor has stopped covering for the absence.
III. The cliff
In March 2021, the American Rescue Plan allocated $39 billion to childcare: $24 billion in direct stabilization grants to providers and $15 billion in supplemental Child Care and Development Block Grant funding. Stabilization grants, administered by HHS's Administration for Children and Families, ultimately reached 220,000 providers serving roughly 10 million children. They paid for rent, utilities, payroll, mental health support, and tuition discounts. They were the closest thing to a national childcare subsidy the United States had ever delivered.
The grants expired on September 30, 2023. The Century Foundation, which modeled the aftermath with economist Jessica Milli ahead of the cliff, projected that approximately 70,000 childcare programs would close and 3.2 million children would lose their slots, with secondary losses of $9 billion in parent earnings, $10.6 billion in state economic activity, and 232,000 childcare-worker jobs.
"Without action, more than 70,000 child care programs are likely to close, and approximately 3.2 million children could lose their child care spots." — Julie Kashen and Laura Valle Gutierrez, The Century Foundation, June 2023
The post-stabilization era has unfolded in slower motion than the cliff metaphor suggested, but the trend lines are now visible in the 2025 data. The Bipartisan Policy Center's September 2025 update to childcaregap.org puts the national supply gap at 28.2 percent — 14.8 million children with potential need against 10.8 million licensed slots, a shortfall of 4.2 million children. CCDBG's FY2024 federal appropriation rose to $8.7 billion, a 9 percent year-over-year increase, but state matching dollars have lagged and total federal-plus-state spending sits in the $14-15 billion range — a fraction of what ARPA briefly provided.
The most visible federal disruption in this report's data window came in November 2025, when a federal government shutdown forced six Head Start programs to close and threatened delayed grant disbursements to dozens more. Head Start, which serves roughly 800,000 of the lowest-income children in the country, runs on annual appropriations; the program has no reserve fund, no state matching backstop, and no political constituency wealthy enough to absorb a missed paycheck.
Provider closures since September 2023 have not matched TCF's worst-case 70,000-program projection — many providers raised tuition, cut hours, dropped infant rooms, or shifted to mixed-age classrooms to stay open. Those adaptations show up in the affordability numbers (tuition rose 13 percent nationally between 2023 and 2024 per Child Care Aware) and in the supply numbers (the gap held steady because demand also fell as families exited the market). What has not happened is a recovery. The post-stabilization market has settled into a more expensive, less available equilibrium — and Congress has not legislated a successor.
IV. The fertility echo
The CDC's National Center for Health Statistics published the final 2024 birth data in NCHS Data Brief No. 535 in July 2025. The total fertility rate fell to 1.626 births per woman — an all-time low for the United States, and well below the 2.1 replacement rate. The general fertility rate dropped to 53.8 births per 1,000 women ages 15-44, a 1 percent decline from 2023. (Total births rose slightly because the population of women ages 15-44 grew faster than the rate fell.) The provisional April 2025 release had shown a 1 percent uptick; the final data revised that to a 1 percent decrease.
Why families are having fewer children is now answerable in a way it was not five years ago. The 2025 American Family Survey, fielded by YouGov for BYU's Wheatley Institute and released at Brookings in November, found that 71 percent of Americans say raising children is unaffordable — a 13-point jump in a single year and a 20-point jump over the past decade. The partisan spread is narrower than usual: 82 percent of Democrats, 64 percent of Independents and Republicans.
"For the first time in the survey's 11-year history, finances are the top reason Americans have capped the size of their family — cited twice as often as any other factor." — Jeremy Pope and Christopher Karpowitz, co-investigators, American Family Survey, BYU, November 2025
Forty-three percent of AFS respondents named "insufficient money" as the primary barrier to having children — the first time finance ranked first in the survey's eleven-year history, and cited twice as often as the next reason ("lack of personal desire"). Boston University economist Abigail Dow's 2025 working paper on childcare prices and fertility found that a 10 percent increase in the price of care for children from birth to age 2 produced a 5.7 percent decrease in the birth rate among women ages 20-44.
This is not the only factor pushing American TFR down — housing costs, student debt, and changing preferences all matter. But it is the first time in the modern era that finances, not values, top the list when Americans explain why they have stopped at fewer children than they wanted.
V. The geography of childcare
Of 250 cities measured in the score, none scored above 80 — the threshold where the methodology labels a place "Excellent." Of 50 states plus the District of Columbia, only North Dakota cleared 70. The American childcare system is not failing equally everywhere, but the baseline is low enough that even the leaders are functioning more on demographic luck than on policy excellence.
The state map runs from North Dakota (score 71) at the top to Nevada (score 23) at the bottom — a 48-point spread. The top five states are all small-population, high-supply markets: North Dakota, New Hampshire (67), Wyoming (65), Maine (63), and Idaho (63), with Vermont a sixth at 63. Each scores in the 88-100 range on supply because licensed capacity has not collapsed under demographic pressure the way it has in larger states. Family Strain scores are also unusually high — North Dakota and Nebraska both clear 80 — reflecting a labor-market structure where mothers' LFP remains strong because the local economy depends on it.
The bottom of the table tells a different story. Nevada (23, the only state in "Crisis" tier), Indiana (30, also Crisis), Hawaii (35), Alaska (38), and New Mexico (39) each fail on a different axis. Nevada combines the country's worst supply environment (2nd percentile) with weak workforce wages and policy support. Indiana has the country's worst affordability score (7th percentile) — center care consumes a brutal share of Hoosier household income. Hawaii is a high-cost island economy with thin policy infrastructure. Each represents a distinct failure mode; none has a near-term fix.
The city map is more dramatic. Pearland, Texas — the highest-scoring city — earned 74, while Sunrise Manor, Nevada earned 14, a 60-point chasm. The top of the city ranking is dominated by Texas suburbs: Pearland (74), McKinney (73), Frisco (73), Plano (69), and Austin (69), joined by Jersey City, NJ (72), Fremont, CA (71), Port St. Lucie, FL (69), Coral Springs, FL (68), and Lubbock, TX (68). The pattern is high-income, family-sized suburban metros where supply has kept pace with demand and where median household income is high enough to absorb sticker-price care.
The bottom of the city ranking is concentrated in two regions. Five of the ten worst-scoring cities are in the Las Vegas metropolitan area — Sunrise Manor (14), Paradise (15), Las Vegas itself (21), North Las Vegas (25), and Spring Valley (26) — reflecting Nevada's statewide collapse multiplied by intense local demand. The rest are scattered: Honolulu (27), Fort Wayne, IN (28), San Bernardino, CA (30), Baton Rouge, LA (30), and Provo, UT (31).
Two regional patterns are worth naming. The Mountain West family-strain anomaly — Provo, Spring Valley, North Las Vegas, San Bernardino — combines low female LFP, large family sizes, and thin licensed supply, and produces the country's most concentrated cluster of "Crisis" tier cities. The high-cost coastal squeeze — New York City (38), Boston (43), Honolulu (27), Long Beach (39) — produces strained scores not because supply is catastrophic but because affordability collapses against the country's most expensive housing markets.
The policy-rich Northeast does not save its largest cities. Massachusetts ranks 32nd of 50 states despite having the country's most generous parental leave law and a state pre-K program in expansion. Boston scores 43. New York state ranks 31st; New York City scores 38. Cost wins.
VI. In-home care: an overlooked relief valve
When licensed center-based care becomes unattainable — by price, by waitlist, by hours-of-operation mismatch with parental jobs — American families turn to private arrangements that sit largely outside federal data systems. The Economic Policy Institute estimates roughly 2.2 million domestic workers in private US homes, including nannies, housekeepers, and home care aides; nanny-employer households alone are conventionally estimated at 1.5 to 2 million, though no clean federal count exists (IRS Schedule H tax noncompliance is estimated above 90 percent).
In-home care is expensive, and it has gotten more so. The 2026 nanny rate data from UrbanSitter, Care.com, and Sittercity converges on a national average of $22 to $26 per hour, putting full-time care for a single family at $50,000 to $60,000 per year — out of reach for all but the top quintile of American households. Nanny shares (two families splitting one nanny) and au pairs (~21,000 enter on J-1 visas annually, with about 29,000 in the country at any time, drawing a federal-minimum stipend of $195.75 per week) extend the model down-market but not far. Federal proposals in 2024 and 2025 to raise the au pair stipend to a true local minimum wage — supported by the National Domestic Workers Alliance and opposed by the State Department's 12 designated sponsor agencies — would price in-home care out of the upper-middle-class entirely.
What in-home care does that center care does not: it absorbs mismatched hours (early shifts, late shifts, weekends), accommodates infants who have been rejected from full center waitlists, and substitutes when a single sick child would otherwise force a working parent to stay home. It is functioning, however unevenly, as a relief valve for the center-based market's failures. It is not a policy solution. It is the private answer of households wealthy enough to write a private check.
VII. What we measured
the score is a 0-100 composite score across five dimensions: Affordability (30 points), Supply (25 points), Workforce Health (15 points), Family Strain (15 points), and Policy Support (15 points). Within each dimension, individual metrics are simple-averaged; across dimensions, they are weighted as above.
Affordability draws on the DOL Women's Bureau National Database of Childcare Prices and the Census ACS B19013 income table to express center-based infant and toddler care as a share of median household income, plus a childcare-to-rent ratio. Supply uses the Bipartisan Policy Center / Buffett / Child Care Aware childcaregap.org dataset (September 2025 release) for licensed slots per 100 children with working parents, alongside BLS QCEW NAICS 624410 establishment counts. Workforce Health pairs BLS OEWS wages (SOC 39-9011) with the EPI Family Budget Calculator's living wage for a single adult. Family Strain uses ACS mothers' labor force participation (women 25-44 with children under 6) and single-parent household share. Policy Support, measured at the state level and inherited by cities within each state, draws on NIEER's State of Preschool Yearbook 2024, HHS ACF CCDF reports, and the National Partnership for Women & Families' state paid-leave tracker.
Every geography is scored against a cohort: 250 cities form one cohort, 50 states form another. Higher-is-better metrics (supply, wages, LFP) and lower-is-better metrics (cost burden, single-parent share) are converted to percentile-ranked 0-100 sub-scores so that all components point in the same direction. The methodology does not compute a single national score — there is no comparison cohort for the United States — which is why this report is structured around tectonic findings rather than a national score.
Methodology. the score is a 0-100 composite score across five dimensions: Affordability (30 pts), Supply (25 pts), Workforce Health (15 pts), Family Strain (15 pts), and Policy Support (15 pts). Each dimension draws on publicly available federal data: U.S. Census American Community Survey (5-year estimates), U.S. Department of Labor Women's Bureau National Database of Childcare Prices, U.S. Bureau of Labor Statistics OEWS and QCEW, the Buffett Early Childhood Institute / Bipartisan Policy Center / Child Care Aware childcaregap.org dataset, the National Institute for Early Education Research (NIEER) State of Preschool Yearbook, and HHS Administration for Children and Families CCDF reports. City-level prices and supply use the city's primary containing county. Policy Support is measured at the state level. Full methodology and data sources: beverly.io/research/methodology.
Sources: U.S. Census Bureau ACS 2019-2023 5-year estimates; U.S. Department of Labor Women's Bureau National Database of Childcare Prices (2018 base, 2023 DOL projection, 2025 forward-projection); Child Care Aware of America Price of Care 2024; U.S. Bureau of Labor Statistics OEWS May 2024 and QCEW 2024; Buffett Early Childhood Institute / Bipartisan Policy Center / Child Care Aware childcaregap.org (Sept 2025); NIEER State of Preschool Yearbook 2024; HHS ACF CCDF FY2023 and FY2024 appropriations; National Partnership for Women & Families state paid-leave tracker (March 2026); CDC NCHS Data Brief No. 535 (July 2025); ReadyNation / Council for a Strong America (Feb 2026); Center for the Study of Child Care Employment Workforce Index 2024; The Century Foundation Child Care Cliff (June 2023); U.S. Surgeon General's Advisory "Parents Under Pressure" (August 2024); Ohio State University Wexner Medical Center National Parental Loneliness Survey (April 2024); KPMG Parental Work Disruption Index (September 2024); BLS LAUS via University of Kansas Care Board; American Family Survey 2025 (BYU Wheatley Institute / YouGov); Economic Policy Institute Domestic Workers Chartbook; U.S. State Department Bureau of Educational and Cultural Affairs (J-1 BridgeUSA).