Medicaid births are a surrogate for children born into poverty. Medicaid is financed by a combination of federal tax dollars and state tax revenues. Survey research has shown that approximately 2/3 of Medicaid funded births are mistimed or unwanted by the mother. Unwanted children face increased rates of child abuse and neglect. To reduce child abuse and neglect and the cost to taxpayers of infant care and foster care, the community could consider strategically investing in access to family planning for the most at risk neighborhoods.