“Obama Administration Allows Fertility Clinics to Sell US Citizenship” cries one website.[1] At issue is, allegedly, not only infertility clinics making big bucks selling U.S. citizenship for babies gestated by American citizens, but access to the entire U.S. benefits system—including education, health, welfare, and retirement services—for them and their foreign parents who have never even lived here. Horrifying.

Shall we dig a little deeper? Here’s the policy: U.S. women whose children are born in a jurisdiction that recognizes them as a legal parent may now transmit citizenship to them, even if their relationship is solely gestational (“biological,”), not genetic.[2] In some jurisdictions, this happens automatically; in others, she must take steps to achieve this outcome.

On the face of it, this policy change seems like a good idea. First, it recognizes gestation as a key element in pregnancy and parenthood, eroding—even if only somewhat—the insistence that only genetic relationships matter. Secondly, it changes policy to recognize technological developments that have already happened: women are bearing babies with whom they have no genetic relationship. In most cases they are doing this to form their own families. In others, they are doing it to help others, often for pay. In either case, their children’s legal status needs to be ensured. Of course, in most cases, no one questions a child’s status since medical records are, in theory, private. However, recent politics shows why legal clarity might be crucial. And, regardless of one’s take on surrogacy, until and unless it is more stringently regulated (or banned) where it is now legal, like the U.S., the status of the children it produces needs clarification as well to prevent babies from being stateless and help ensure that parents and babies can live together.

True, this change might allow determined parents to buy U.S. citizenship for their children, a generally unappealing wrinkle. However, some countries, including the U.S., already have other provisions for people to acquire citizenship or resident status if they have the price of admission. So if you had the spare cash ($800,000CAN) to lend the Canadian government, you could until recently qualify for citizenship. Or, you can get a U.S. green card if you invest half a million dollars and create at least ten jobs. Or, if you buy a property worth at least 250,000 euros, you can get a five year residence permit in Greece. Of course, the infertility clinic route would be somewhat cheaper, but critical scrutiny really should be directed at the broader policies aimed at recruiting wealthy immigrants, not focused on this one relatively minor example.

What about the worry that these children (and their families) will have access to U.S. benefits even if they’ve never lived here? For the most part, this seems rather a stretch. Public education is unavailable if you live outside country, and you need to live in the relevant district, as we see from cases where parents have been jailed for sending their kids to the “wrong” school.[3] If you do live in the appropriate district, you are paying for its schools, whether via property taxes or rent. Medicaid/Obamacare? There continue to be huge coverage gaps for both programs that leave many with no access to affordable care.[4] Medicare? If you haven’t paid Medicare taxes for 30 quarters, your monthly fee for Part A is $426 a month; you cannot sign up for Part B unless you live in the U.S., and the basic monthly fee is $104. So it would cost $1060 a month for a couple to get Medicare if they moved to the U.S, not exactly a free lunch, especially when you consider that it aims at paying only for about 80% of one’s medical expenses. Nor is there any upper limit beyond which it pays 100%. Most people would do better to stick with their home state national health care systems. Social Security? Not unless you’ve paid your FICA tax for 40 quarters. So, by and large, Americans do pay for their benefits and there is no obvious way foreigners who haven’t done so to get access to them—or what there might be left after the opponents of government services are done with them.[5]

What about the point that infertility clinics will make hay from its gatekeeping role here? Here I agree with The Daily Call: this is a morally abhorrent consequence. The obvious solution, not just for this problem but for the state of infertility services generally, is tight regulation.[6] In fact, I would argue for going still further: the only way to keep the price of infertility services somewhere near what they really cost would be either price controls or banning all but non-profit clinics.[7] Of course hell will freeze over before readers of The Daily Call would approve of that approach.

One last point: U.S. citizenship might not be an unmitigated good for some foreigners. Why? U.S. citizens must now report all non-U.S. bank accounts, and the failure to do so can potentially generate huge fines, even if one were unaware of one’s status as citizen or ignorant of the law. In addition, the U.S. taxes world income; living in a country without a tax treaty that prevents double taxation could get very expensive indeed.

So, despite the horrors conjured up by this headline, I think it’s safe for us to get back to work on the many real problems facing humanity.

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[1] The Daily Caller, 10/28/2014, Neil Munro, http://dailycaller.com/2014/10/28/obama-administration-allows-fertility-clinics-to-sell-us-citizenship/#disqus_thread; thanks to Patrick Welsh for bringing this issue to my attention.

[2] USCIS Policy Manual, http://www.uscis.gov/policymanual/HTML/Plicy Manual-Volume 12-PartH-Chapter2.html#S-E.

[3] “Stealing” Free Education? Homeless Mother Gets Jail Time for Sending her Son to a Better School District, Alternet, Feb. 28,2012, http://www.alternet.org/newsandviews/article/818811/%22stealing%22_free_education_homeless_mother_gets_jail_time_for_sending_her_son_to_a_better_school_district.

[4] Medicaid Eligibility for Adults as of January 1, 2014, October 1, 2013, http://kff.org/medicaid/fact-sheet/medicaid-eligibility-for-adults-as-of-january-1-2014/.

[5] The Daily Caller article also fears that the U.S. will be over-run by the foreign fruits of this policy, but that point will be left to the obscurity it deserves.

[6] See my “Surrogate Mothering: Exploitation or Empowerment?” and “Another Look at Contract Pregnancy,” both reprinted in my Reproducing Persons: Issues in Feminist Bioethics (Ithaca: Cornell University Press, 1996).

[7] See my “In Vitro Fertilization Should Be an Option for Women,” in Contemporary Debates in Bioethics, eds Arthur L. Caplan and Robert Arp (John Wiley & Sons, 2013).