Penalizing Parenthood and Perpetuating Poverty: Black Parents’ Perspectives on Wisconsin’s Birth Cost Recovery Policy

Social safety-net policies and programs are often a double-edged sword—they provide necessary resources, but also punish poor Americans. In Wisconsin, one policy that exemplifies this pattern is Birth Cost Recovery, a state-enforced cost recovery policy through which unmarried, non-custodial fathers are required to repay Medicaid-covered delivery expenses. Supporters assert that Birth Cost Recovery promotes paternal responsibility and increases the sustainability of safety-net programs, but opponents contend it has detrimental effects on families. Yet few studies have explored Birth Cost Recovery, leaving policymakers with an inadequate understanding of its consequences. To address this knowledge gap, we conducted semi-structured interviews with Black parents in Wisconsin (N = 40), a population that is disproportionately affected by Birth Cost Recovery policies. Interviewers asked parents about their experiences with Birth Cost Recovery, their views on the policy, and its impact on their families. Applying the Sort and Sift, Think and Shift approach to thematic analysis, we identified three themes. First, parents impacted by Birth Cost Recovery expressed confusion about the policy and often conflated it with Medicaid and child support. Second, interviewees described Birth Cost Recovery as a form of social control that regulates behavior by penalizing those who challenge societal norms. Third, research participants highlighted the policy’s consequences for Black families, including negative impacts on their financial and familial well-being that participants understood as compounding existing economic disadvantage and reproducing structural inequities. The findings reveal an urgent need for policy reform and deeper scrutiny of contemporary poverty governance.