Directs the Department of Health and Human Services, Division of Child Development and Early Education (Division) to study the North Carolina Pre-K and North Carolina Smart Start programs, including review of (1) complete allocation of funds for the programs, (2) other early childhood models that may better maximize funds for child care needs, and (3) current rules and guidelines for the quality rating improvement system to allow child care providers to offer child care to as many children as possible. Requires the Division to conduct an analysis of the Pre-K system to ensure every funded slot can be filled, and directs that the Division should reassign any open slots to counties with a waiting list. Permits the Division to increase class sizes to 22 in counties with available slots but no additional teachers or classrooms. Directs the Division to study current child care subsidy rates to determine a recommended minimum. Requires the Division to report its findings and recommended legislative action to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division on or before April 30, 2026.

Appropriates $10,000,000 from the General Fund for each year of the 2025-27 biennium to the Division for a pilot program where all teachers employed full time by a licensed child care program are automatically eligible for preschool-age child care subsidies. Requires the eligible teachers to be enrolled or in the process of enrolling in an Introduction to Early Childhood class, and to commit to remaining in college and completing either an Early Childhood Education Infant/Toddler Certificate or Child Development Certificate within 18 months. Provides that the coursework will be covered by the T.E.A.C.H. Early Childhood North Carolina Scholarship Program, with no cost to the teacher. Requires the Division to implement the pilot program within 120 days of July 1, 2025. Requires the Division to report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division by March 31, 2026, on the number of child care teachers in the pilot program by county, and to make quarterly reports thereafter. Specifies that the quarterly reports, and annual reports due by December 31st of each year, must contain (1) the number of teachers in the pilot program already teaching who became automatically eligible, (2) the number of new teachers added, by county, on a monthly basis, and (3) the retention of teachers in the pilot program. Effective July 1, 2025.

Mandates that funds appropriated for the Pilot Program to Increase the Provision of In-Home Child Care from SL 2023-134 and the Tri-Share Child Care Pilot Program from SL 2023-134 are subject to review and approval by the General Assembly before the Division can expend the funds for either program.

Specifies that any county providing supplemental child care funds must allow families to select a four- or five-star rated child care center of their choice.

Directs the Department of Health and Human Services to collaborate with the Department of Insurance to suggest ways to lower insurance costs for child care in the state.