Quiet Policy Change Saves Milwaukee County Fathers $67 Million

Milwaukee County Courthouse. Photo by Graham Kilmer.

A policy change last year has saved thousands of parents in Milwaukee County more than $60 million.

In 2023, the Milwaukee County Board voted to end the county’s Birth Cost Recovery program, which had the county’s child support agency go after fathers for costs associated with childbirth when the mother was a recipient of Medicaid. The recovered funds are sent to the state and federal government, but the county’s child support agency is allowed to keep approximately 15% of all collections.

In Milwaukee, and elsewhere, the program was a source of racial disparities. Data from 20020 showed that nearly half of all the men forced to repay childbirth costs in Milwaukee were Black. And while birth recovery is not a child-support program, a study by UW-Madison researchers published in May 2023 found that ending the practice was correlated with improved child support payments for Black families.

The goal for the county was to eliminate an additional financial burden on young families in Milwaukee and another source of racial and economic disparity. Because the program only covers families when the mother is on Medicaid, it is often aimed at families living in poverty. A fact the UW-Madison researchers noted after studying the end of birth cost recovery in Dane County in 2020. In Milwaukee, fathers who make as little as approximately $25,000 annually are eligible for birth cost recovery.

“There are glaring racial disparities in the Birth Cost Recovery system,” County Executive David Crowley said in 2023. “To achieve race and health equity and become the healthiest county in the state, it’s critical Milwaukee County discontinues this practice.”

During the 2024 budget process, Sup. Caroline Gómez-Tom authored an amendment ending the county’s Birth Cost Recovery practice. Along with the county executive, the proposal was supported by leaders of the county’s Department of Health and Human Services (DHHS) and Child Support Services (CSS) the agency the runs the program.

The agency stopped collecting childbirth costs the day the budget was passed in November. In late July, the Wisconsin Department of Children and Families (DCF) agreed to eliminate the childbirth costs for county residents. The eliminated costs totaled $67 million.

“I’m incredibly pleased that we were able to work together to remove a significant financial burden from fathers in Milwaukee County, officially ending an antiquated practice dating back to the 1970s,” Gómez-Tom said in a statement. “We want to do everything we can to support families in our community. The end of birth cost recovery stops a practice that disproportionately affected families of color and is an investment in equity.”

As the UW-Madison study noted, local governments and child support agencies in Wisconsin have been hesitant to discontinue the practice. Supporters of the program argue that it encourages parental responsibility in unwed fathers and helps fund the state’s Medicaid program.

The results of the Dane County study were also mixed. The study found a correlation between the ending of the program and lower employment rates among eligible fathers. However, it began in 2020, and the onset of the COVID-19 pandemic and its attendant economic consequences affected the researchers’ data. The study also found that, while child support payments improved for Black fathers it worsened for white fathers.

In 2024, CSS was merged into the county’s larger Department of Health and Human Services. Before that it was a stand-alone department, and under former director Jim Sullivan, opposed ending birth cost recovery, arguing that it would affect the department’s budget.

“DHHS strives to give kids and families the best start in life, through prevention and intervention,” said DHHS Director Shakita LaGrant-McClain. “Now that Child Support Services is part of DHHS, it helps us widen the net and bridge the gap to offer more options to ensure kids in our community have the support they need.”

Opponents of the recovery program, including the county executive, argue birth cost recovery is a burden to new fathers and does little to support families.

“I remain deeply committed to addressing race and health equity in Milwaukee County. To accomplish that, we need to invest in families and support parents. Eliminating birth costs will give fathers more resources to support themselves and their children, and that’s what matters to me,” Crowley said. “The positive impact of ending this practice far outweighs any negative implications. We will continue doing everything we can to support families, children, and the future of Milwaukee County.”