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Birth Cost Recovery in Wisconsin: "It's Not Child Support."

 

 

Publications/Reports | Correspondence | Research | Federal Statute/Rules | Wisconsin Statute/Rules

WI Collections by County | Good Cause Exemption | Other States

 

Introduction
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Birth Cost Recovery (BCR) is a practice allowed, but not required, under title IV-D of the federal Social Security Act that allows states to pursue the recovery of Medicaid supported birthing costs from non-custodial fathers.  Most states in the nation have abandoned this practice concluding that it is not in the best interest of infants, parents and families.

 

Wisconsin is among a small handful of states that continues to pursue this policy, and takes the most aggressive enforcement posture in the nation, collecting over $16 million in 2016.  Unlike child support, none of the recovered dollars go to support the children and families – it is all directed to reimburse the government at the federal, state and local level.

 

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ABC for Health is concerned that the policy has long been harming efforts to reduce infant mortality, lift families out of poverty and encourage unmarried fathers to play an important, supportive role in their children’s lives.  We have advocated that Wisconsin abandon the policy altogether, or at a minimum, modify it to reduce the negative, unintended consequences to our children and families. 

 

This webpage provides a compilation of links to research materials, publications, correspondence and background materials for individuals interested in the subject of BCR.

Publications & Reports, ABC for Health, Inc.

ABC for Health has written a number of background papers on BCR and submitted several editorials over the years pointing to the potential negative consequences of this practice.

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Correspondence, ABC for Health, Inc.

ABC for Health has written government officials in Dane and Milwaukee Counties – the two Wisconsin Counties recovering the most in birth cost judgements – asking for opportunities to meet with government staff, discuss concerns about BCR and plan efforts to reduce the potential negative impacts on children and families.  Below are letters, correspondence and information pertinent to these two counties. Email us for access to the correspondence.

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Dane County

  • Letter to Dane County Executive Parisi and Mayor Paul Soglin, March 17, 2017
  • Letter to Dane County Executive Parisi, August 9, 2017
  • BCR Collections 2011-2016
  • Dane County Budget Meeting
  • Parisi Response Email, August 15, 2017

Milwaukee County

  • Letter to Milwaukee County Executive Abele and Mayor Tom Barrett, March 17, 2017
  • Letter to Milwaukee County Executive Abele, August 9, 2017
  • Response Letter from Jim Sullivan, Milwaukee Director of Child Support Services, October 2, 2017
  • Letter to Jim Sullivan, Milwaukee Director of Child Support Services, October 24, 2017
  • BCR Collections 2011-2016

Supporting Evidence, ABC for Health, Inc.

ABC for Health has written government officials in Dane and Milwaukee Counties – the two Wisconsin Counties recovering the most in birth cost judgements – asking for opportunities to meet with government staff, discuss concerns about BCR and plan efforts to reduce the potential negative impacts on children and families.  Below are letters, correspondence and information pertinent to these two counties. Email us for access to the correspondence.

There is a small, but growing, body of evidence which supports the position that BCR is not in the best interest of mothers, fathers, infants and families.  Below are a few of the articles that deal with the issue of BCR.

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Wisconsin’s Birth Cost Recovery Policy: Implications for Health Disparities in Infant Mortality.  May 17, 2012.  Capstone Manuscript, University of Wisconsin School of Medicine and Public Health.

Cancian, Maria, et.al.  2009.  Does Debt Discourage Employment and Payment of Child Support?  Evidence from a Natural Experiment.  Institute for Research on Poverty, University of Wisconsin – Madison

Congressional Research Service.  December 18, 2013.  Medical Child Support:  Background and Current Policy.  Report No. R43020

Bartfield, Judy.  2005.  Arrearages, Lying-in Orders, and Child Support Compliance among Fathers of W-2 Children in Wisconsin.  Institute for Research on Poverty, University of Wisconsin – Madison.

Boggess, Jacquelyn.  2017.  Low-income and Never-Married Families.  Service and support at the intersection of family court and child support agency systems.  Center for Family Policy and Practice.

The Medical Child Support Working Group’s Report. June 2000. 21 Million Children’s Health: Our Shared Responsibility

Roberts, Paula. May 2011. An Ounce of Prevention and a Pound of Cure: Developing State Policy on the Payment of Child Support Arrears by Low Income Parents.

Mistry, Ritesh et al. July 2007. Parenting-Related Stressors and Self-Reported Mental Health of Mothers with Young Children.

Solomon-Fears, Carmen. Medical Child Support: Background and Current Policy. December 18, 2013.

Birth Cost Recovery Poverty Matters

Federal Statute/Rules Related to BCR

The practice by which states seek repayment of Medicaid related birth costs from third parties, including non-custodial fathers, is authorized in federal statute and regulation.  Below are related links:

 

Section 1912(a) of the Social Security Act

Wisconsin Statute/Administrative Rules Related to BCR

Wisconsin’s framework for implementing BCR is spelled out in statute and administrative rule.  Below are relevant links:

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Wis. Stat. 49.22: child and spousal support and establishment of paternity

Wis. Stat. 767.80(6m): CSA is required to file a paternity action for any case in which the father is not listed.

DCF 150.01(1)

Wisconsin BCR Collections by County, 2011-2016

Repayment of MA related birth cost expenses is pursued by individual Child Support Enforcement Agencies at the county level.  Counties are allowed to retain 15% of annual BCR collections to support child support enforcement programming.  The Wisconsin Department of Children and Families provided this spreadsheet breaking out collections by Wisconsin county for the years 2011 through 2016.

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View BCR Collections by County

Good Cause Exemption

Unmarried mothers who are concerned about the potential negative consequences of identifying the father of their child can request a “Good Cause Exemption.”  Below are links that explain the process and requirements for “Good Cause” consideration.

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BadgerCare Plus 5.3

Good Cause Claim Form

Dane County Child Support Manual on Good Cause & Non-Cooperation

Information Regarding Other State Approaches to BCR

In 2010, a survey indicated that only nine states in the nation continued to practice BCR.  A follow-up email survey of these states in 2017 provided more recent insights into their current BCR practices. In 2014, Idaho stopped pursuing BCR completely.

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Idaho

New York

Kansas

Pennsylvania

Michigan

Minnesota

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HealthWatch Wisconsin, Inc. | 608.261.6939 | 32 N. Bassett St. Madison, WI

HealthWatch Wisconsin, Inc, a subsidiary of ABC for Health, promotes improved access to health care coverage and services. HealthWatch will continue to track and inform policy developments in a changing landscape of public and private insurance coverage options for the people of Wisconsin.

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