Unborn Child Support Act

— 501 — Department of Health and Human Services 54. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Office of Civil Rights, and Office of the Secretary, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,” draft of Proposed Rule, January 14, 2021, https://www.hhs.gov/sites/default/files/infants-nprm.pdf (accessed March 17, 2023). 55. H.R. 26, Born-Alive Abortion Survivors Protection Act, 118th Congress, introduced January 9, 2023, https:// www.congress.gov/118/bills/hr26/BILLS-118hr26pcs.pdf (accessed March 17, 2023). 56. H.R. 7, No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2023, 118th Congress, introduced January 9, 2023, https://www.congress.gov/118/bills/hr7/BILLS-118hr7ih.pdf (accessed March 17, 2023). 57. S. 401, Conscience Protection Act of 2021, 117th Congress, introduced February 24, 2021, https://www.congress. gov/117/bills/s401/BILLS-117s401is.pdf (accessed March 17, 2023). 58. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, and Office of the Secretary, “Nondiscrimination in Health Programs and Activities,” Notice of Proposed Rulemaking; Notice of Tribal Consultation, Federal Register, Vol. 87, No. 149 (August 4, 2022), pp. 47824–47920, https://www.govinfo. gov/content/pkg/FR-2022-08-04/pdf/2022-16217.pdf (accessed March 17, 2023). 59. Ibid., p. 47916. 60. The regulation was not finalized before the end of the Administration. U.S. Department of Agriculture, Food and Nutrition Services, “Revision of Categorical Eligibility in the Supplemental Nutrition Assistance Program (SNAP),” Proposed Rule, Federal Register, Vol. 84, No. 142 (July 24, 2019), pp. 35570–55581, https:// www.federalregister.gov/documents/2019/07/24/2019-15670/revision-of-categorical-eligibility-in-the- supplemental-nutrition-assistance-program-snap (accessed March 17, 2023). 61. 45 Code of Federal Regulations § 75.300(c) and (d), https://www.ecfr.gov/current/title-45/subtitle-A/ subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.300 (accessed March 17, 2023). 62. H.R. 1750, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https:// www.congress.gov/117/bills/hr1750/BILLS-117hr1750ih.pdf (accessed March 17, 2023), and S. 656, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https://www.congress.gov/117/bills/ s656/BILLS-117s656is.pdf (accessed March 17, 2023). 63. S. 3949, Trafficking Victims Protection Reauthorization Act of 2022, Public Law No. 117-348, 117th Congress, January 25, 2023, https://www.congress.gov/117/plaws/publ348/PLAW-117publ348.pdf (accessed March 17, 2023). 64. Kelsey Y. Santamaria, “Child Migrants at the Border: The Flores Settlement Agreement and Other Legal Developments,” Congressional Research Service In Focus No. IF11799, April 1, 2021, https://crsreports.congress. gov/product/pdf/IF/IF11799 (accessed March 17, 2023). 65. Report, Building a Happy Home: Marriage Education as a Tool to Strengthen Families, Social Capital Project Report No. 1-22, March 2022, p. 17, https://www.jec.senate.gov/public/_cache/files/3d102525-6f0d-48ed- 92f4-d71edd468ad6/building-a-happy-home.pdf (accessed March 17, 2023). The cover of the report reflects that the Social Capital Project is “[a] project of the Joint Economic Committee – Republicans.” 66. See, for example, Alan J. Hawkins, “Are Federally Supported Relationship Education Programs for Lower-Income Individuals and Couples Working? A Review of Evaluation Research,” American Enterprise Institute, September 2019, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 67. H.R. 8404, Respect for Marriage Act, Public Law No. 117-228, 117th Congress, December 13, 2022, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 68. Madison Marino, “Over 1,000 Safety Violations Mar Head Start. Children Deserve Better,” Heritage Foundation Commentary, November 10, 2022, https://www.heritage.org/education/commentary/over-1000-safety- violations-mar-head-start-children-deserve-better. 69. American Hospital Association v. Becerra, 596 U.S. ___ (2022), https://www.supremecourt.gov/ opinions/21pdf/20-1114_09m1.pdf (accessed March 17, 2023). 70. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, “Coverage of Certain Preventive Services Under the Affordable Care Act,” Notice of Proposed Rulemaking, Federal Register, Vol. 88, No. 22 (February 2, 2023), pp. 7236–7281, https://www. govinfo.gov/content/pkg/FR-2023-02-02/pdf/2023-01981.pdf (accessed March 17, 2023). — 502 — Mandate for Leadership: The Conservative Promise 71. 42 U.S. Code § 238n, https://www.law.cornell.edu/uscode/text/42/238n (accessed March 17, 2023). 72. U.S. Department of Health and Human Services, Health Resources and Services Administration, “Early Childhood Health,” last reviewed October 2022, https://mchb.hrsa.gov/programs-impact/focus-areas/early- childhood-health (accessed March 17, 2023). 73. American Pregnancy Association, “Having a Doula—What Are the Benefits?” https://americanpregnancy. org/healthy-pregnancy/labor-and-birth/having-a-doula/#:~:text=Other%20studies%20have%20shown%20 that%20having%20a%20doula,massage%20to%20reduce%20stress%20and%20anxiety%20during%20labor (accessed March 17, 2023). 74. S. 2372, VA MISSION [Maintaining Internal Systems and Strengthening Integrated Outside Networks] Act of 2018, Public Law No. 115-182, 115th Congress, June 6, 2018, https://www.congress.gov/115/plaws/publ182/ PLAW-115publ182.pdf (accessed March 17, 2023). 75. U.S. Department of Health and Human Services, “Securing Updated and Necessary Statutory Evaluations Timely,” Final Rule, Federal Register, Vol. 86, No. 11 (January 19, 2021), pp. 5694–5764, https://www.govinfo. gov/content/pkg/FR-2021-01-19/pdf/2021-00597.pdf (accessed March 22, 2023). 76. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Compliance with Statutory Program Integrity Requirements,” Final Rule, Federal Register, Vol. 84, No. 42 (March 4, 2029), pp. 7714–7791, https://www.govinfo.gov/content/pkg/FR-2019-03-04/pdf/2019-03461.pdf (accessed March 18, 2023). 77. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Ensuring Access to Equitable, Affordable, Client-Centered, Quality Family Planning Services,” Final Rule, Federal Register, Vol. 86, No. 192 (October 7, 2021), pp. 56144–56180, https://www.govinfo.gov/content/ pkg/FR-2021-10-07/pdf/2021-21542.pdf (accessed March 18, 2023). 78. S. 624, Title X Abortion Provider Prohibition Act, 118th Congress, introduced March 2, 2023, https://www. congress.gov/118/bills/s624/BILLS-118s624is.pdf (accessed March 18, 2023). 79. 50 U.S. Code Chapter 55, https://www.law.cornell.edu/uscode/text/50/chapter-55 (accessed March 22, 2023). 80. 18 U.S. Code § 13, https://www.law.cornell.edu/uscode/text/18/13 (accessed March 18, 2023). 81. Bowen v. American Hospital Association, 476 U.S. 610 (1986), https://tile.loc.gov/storage-services/service/ll/ usrep/usrep476/usrep476610/usrep476610.pdf (accessed 22, 2023). 82. U.S. Department of Health and Human Services, Office of the Secretary, “Notification of Interpretation and Enforcement of Section 1557 of the Affordable Care Act and Title IX of the Education Amendments of 1972,” Federal Register, Vol. 86, No. 99 (May 25, 2021), pp. 27984–27985, https://www.govinfo.gov/content/pkg/FR- 2021-05-25/pdf/2021-10477.pdf (accessed March 18, 2023). 83. U.S. Department of Health and Human Services, Office for Civil Rights, “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy,” March 2, 2022, https://www.hhs.gov/sites/default/files/hhs- ocr-notice-and-guidance-gender-affirming-care.pdf (accessed March 18, 2023). 84. Heckler v. Chaney, 420 U.S. 821 (1985), https://caselaw.findlaw.com/us-supreme-court/470/821.html (accessed March 18, 2022). 85. U.S. Department of Health and Human Services, Office for Civil Rights, “Guidance to Nation’s Retail Pharmacies: Obligations Under Federal Civil Rights Laws to Ensure Access to Comprehensive Reproductive Health Care Services,” content last reviewed July 14, 2022, https://www.hhs.gov/civil-rights/for-individuals/ special-topics/reproductive-healthcare/pharmacies-guidance/index.html (accessed March 18, 2023). 86. H.R. 3103, “Health Insurance and Portability and Accountability Act of 1996, Public Law No. 104-191, 104th Congress, August 21, 1996, https://www.congress.gov/104/plaws/publ191/PLAW-104publ191.pdf (accessed March 18, 2023). 87. U.S. Department of Human Services, “HIPAA Privacy Rule and Disclosures of Information Relating to Reproductive Health Care,” content last reviewed June 29, 2022, (accessed March 18, 2023). See also “Protecting the Privacy and Security of Your Health Information When Using Your Personal Cell Phone or Tablet,” content last reviewed June 29, 2022, https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/ cell-phone-hipaa/index.html (accessed March 18, 2023).

— 479 — Department of Health and Human Services dads, and now as “disconnected” dads who do not commit to the mother and child. Child support in the United States should strengthen marriage as the norm, restore broken homes, and encourage unmarried couples to commit to marriage. Child Support Tax Credit. National or state guidelines and tax law should be updated to ensure that nonresident parents with child support orders can receive a nondependent, child support tax credit. Single filers of up to $41,756 and married or joint filers of up to $47,646 would be eligible for a child support tax credit similar to the current earned income tax credit. Filers could receive a maximum of $538 in annual returns for one child and a maximum of $3,584 in annual returns for two or more children (based on a credit rate of 34 percent). A child support tax credit would use the low-income, nonresident parents’ own earned income and history of employment to assist them further in the task of caring for their children. The key to this policy is that it empowers fathers with their own resources and money rather than creating another government assistance program (or a fully refundable credit) devoid of the father’s own monetary efforts. This way, the non- resident father’s role as financial provider and relational figure is affirmed, and much-needed financial resources are given to the children. Visitation. Visitation is key to revitalizing child support and increasing pay- ment frequency. The most effective way to lower a nonresident parent’s monthly child support order is to spend more court-accounted-for time with the child. For example, Texas combined its child support court with its visitation court to ensure that resident and nonresident parents received state-mandated financial support orders and enforceable visitation orders. Child Support Payment and Interactive Smartphone Application. Each state should be induced to implement a high-tech, easy-to-use application to cen- tralize child support payments. As with Venmo or Cash App, nonresident parents would link their bank accounts and provide one-click monthly payments (or con- tribute incrementally throughout the month while tracking how much is due). Additionally, the nonresident parents could track “informal” gifts from money, groceries, clothes, sports gear, and more through the app. This would address one of the main issues within current child support pay- ment systems: nonresident parents claim that they are spending much of their own money to provide for children outside of their monthly payments and resident parents’ claim that they spend little and neglect their official child support orders. Currently, only the latter claim can be tracked reliably. This process would enable nonresident parents to track the amount of informal support they provide and the reason for it while ensuring that the resident parent acknowledges and accepts the contribution. Healthy Marriage and Relationship Education (HMRE) Program. The HMRE program is part of the ACF Office of Family Assistance. The following pol- icies should be implemented.

— 479 — Department of Health and Human Services dads, and now as “disconnected” dads who do not commit to the mother and child. Child support in the United States should strengthen marriage as the norm, restore broken homes, and encourage unmarried couples to commit to marriage. Child Support Tax Credit. National or state guidelines and tax law should be updated to ensure that nonresident parents with child support orders can receive a nondependent, child support tax credit. Single filers of up to $41,756 and married or joint filers of up to $47,646 would be eligible for a child support tax credit similar to the current earned income tax credit. Filers could receive a maximum of $538 in annual returns for one child and a maximum of $3,584 in annual returns for two or more children (based on a credit rate of 34 percent). A child support tax credit would use the low-income, nonresident parents’ own earned income and history of employment to assist them further in the task of caring for their children. The key to this policy is that it empowers fathers with their own resources and money rather than creating another government assistance program (or a fully refundable credit) devoid of the father’s own monetary efforts. This way, the non- resident father’s role as financial provider and relational figure is affirmed, and much-needed financial resources are given to the children. Visitation. Visitation is key to revitalizing child support and increasing pay- ment frequency. The most effective way to lower a nonresident parent’s monthly child support order is to spend more court-accounted-for time with the child. For example, Texas combined its child support court with its visitation court to ensure that resident and nonresident parents received state-mandated financial support orders and enforceable visitation orders. Child Support Payment and Interactive Smartphone Application. Each state should be induced to implement a high-tech, easy-to-use application to cen- tralize child support payments. As with Venmo or Cash App, nonresident parents would link their bank accounts and provide one-click monthly payments (or con- tribute incrementally throughout the month while tracking how much is due). Additionally, the nonresident parents could track “informal” gifts from money, groceries, clothes, sports gear, and more through the app. This would address one of the main issues within current child support pay- ment systems: nonresident parents claim that they are spending much of their own money to provide for children outside of their monthly payments and resident parents’ claim that they spend little and neglect their official child support orders. Currently, only the latter claim can be tracked reliably. This process would enable nonresident parents to track the amount of informal support they provide and the reason for it while ensuring that the resident parent acknowledges and accepts the contribution. Healthy Marriage and Relationship Education (HMRE) Program. The HMRE program is part of the ACF Office of Family Assistance. The following pol- icies should be implemented. — 480 — Mandate for Leadership: The Conservative Promise l Utilize HMRE funding or grants to provide state-level high school education resources and curriculum on healthy marriages, sexual risk avoidance, and healthy relationships. Early interventions and prevention are much more cost-effective than are efforts to reach people already in broken relationships. l Allow child welfare funding to be used for marriage and relationship education. Congress should adopt the following recommendation from a report issued by members of Congress’s Joint Economic Committee: Children are far more likely to experience abuse when they are raised outside of their married-parent family. Title II of the Child Abuse Preven- tion and Treatment Act provides grants to communities for the purpose of preventing child abuse and neglect, and one of the stated purposes for which the grants can be used is for efforts to increase family stability. However, Congress could change the law to make it clear that Title II funding can be used for healthy marriage and relationship education. Funding provided under Title IV-B of the Social Security Act—which provides grants to states for foster care and adoption services—can also be used for promoting healthy marriage. States should consider using some of their Title IV-B funding for providing healthy marriage and relationship education for families at risk of having their children placed in foster care.65 l Provide educational information on healthy marriage and relationships at Title X family planning clinics. HHS should require clinics it funds under Title X (family planning) to provide information to customers about the importance of marriage to family and personal well-being and refer them to available federal, state, and nonprofit marriage resources. l Ensure proper assessments with enough time to assess HMRE programs. Although some widely available assessments of HMRE programs report poor outcomes, many of these assessments either utilized a poor methodology or tried to measure program success prematurely. Recent assessments have shown increasing effectiveness and positive community- level marital outcomes.66 The HMRE program should receive a fair and realistic assessment. Additionally, the positive role of faith-based programs should be protected