Madison, WI – Dane and Milwaukee Counties used the 2024 budget process to end the inequitable birth cost recovery policy. Dubbed the “Birth Tax” by ABC for Health, the 2024 Milwaukee County Budget eliminated the unjust and racially inequitable policy of Birth Cost Recovery under the leadership of Supervisor Caroline Gomez-Tom. Dane County, under the stewardship of County Board Supervisors Richelle Andrae and Heidi Wegleitner, took further steps to end the collection of pre-2020 Birth Cost Recovery judgments and support efforts to inform affected families about their rights in the process.
But Brynne McBride, Public Interest Attorney at ABC for Health, Inc. says there is more work to do to end the Birth Tax across Wisconsin. “Absent state action, other counties like Brown, Racine, Kenosha, Eau Claire, and Outagamie Counties need to end the Birth Tax and these county-sponsored medical collections actions.”
The Birth Tax is a county-driven medical debt collections process that affects pregnant persons across Wisconsin, especially women of color. McBride explained the Birth Tax is NOT child support, but rather “an inequitable medical collections process” coordinated by state agencies and run by counties to recover birth expenses for unmarried people on Wisconsin Medicaid. In fact, none of the money collected directly supports the affected children or families.
McBride says, “The pregnant person is the individual stressed by the policy, forced to make difficult choices about relationships and consequences that include initiating the collections process for a partner or facing sanctions and termination of Medicaid 60 days post-partem. At a time when women’s health is already under attack and where research supports more coverage post-partem, not less, the archaic policy simply does not make sense.” A report issued by ABC for Health in late 2022 highlighted: 66% of Medicaid-covered deliveries in Wisconsin in 2020 were to unmarried persons. For white Wisconsinites, 58% of deliveries were to unmarried families. For Black Wisconsinites, 88% of Medicaid deliveries were to unmarried families.
While celebrating this long-fought policy win, McBride says they plan to keep a close eye on child support offices in Milwaukee and Dane Counties, and hold them accountable to the new policy change, and prevent delayed policy implementation that would harm more unmarried families on Medicaid. Moreover, she says there is more work needed in Milwaukee, where old judgments from prior to 2024 are, sadly, still fair game for the county debt collectors at child support.
ABC for Health, Inc., is a Wisconsin-based, nonprofit, public interest law firm that promotes health equity and social justice. ABC for Health helps clients impacted by health disparities due to income, race, or poverty to connect to health care coverage and services in Wisconsin. ABC for Health’s mission is to provide information, advocacy tools, legal services, and expert support needed to obtain, maintain, and finance health care coverage and services.
