FAIR: Birthright citizenship costs taxpayers $150.7B annually

Policy analysts warn that broad constitutional interpretations of birthright citizenship under the 14th Amendment have enabled foreign nationals to exploit legal loopholes through organized "birth tourism" and commercial surrogacy operations in states such as California, New York and Florida. Surrogacy operations are also common in Northern Mariana Islands, a U.S. territory about 1,000 miles south of Japan.

"Misinterpretation has led to a number of unfortunate and really harmful unintended consequences, with birth tourism being sort of one of those unintended consequences of a misreading of the Constitution," said Mateo Forero, director of investigations at FAIR, who was interviewed by The Center Square.

Birth tourism made headlines again after a high-profile surrogacy case in Los Angeles County involving alleged abuse of surrogate-born children. Guojun Xuan, 66, and Silvia Zhang, 39, both of Arcadia, were charged with one count each of conspiracy to commit child abuse. Xuan also faces one felony count of child abuse, one felony count of accessory after the fact and five felony counts of dissuading a witness. There was a total of 21 children born from surrogates.

Mitchell Krems, Xuan's attorney, told The Center Square that Xuan is a U.S. citizen, but efforts by The Center Square and other media to determine Zhang's citizenship status has been unsuccessful. Krems has told reporters that Xuan and Zhang are Chinese immigrants.

The couple are in jail in lieu of $20 million bail, and their next hearing will be Friday at Los Angeles County Superior Court in Pasadena. They've pleaded not guilty.

Questions over surrogates giving birth to immigrants' children are being raised as the Trump administration continues its efforts to target birthright citizenship and birth tourism. In August 2026, just five weeks after the U.S. Supreme Court struck down Trump’s initial broad executive order restricting birthright citizenship in Trump v. Barbara, the president signed two new executive orders. One focuses on "ending birth tourism," while the other aims at "continuing to protect the meaning and value of American citizenship."

FAIR filed amicus briefs at two stages of the Trump v. Barbara case, arguing for the original 19th-century understanding of the 14th Amendment. FAIR expressed disappointment with the justices' ruling that everyone born in the U.S. is an American citizen, regardless of their parents' background.

However, Forero noted that the administration’s revised approach on birth tourism takes a creative angle aimed directly at the legal gaps left by the Supreme Court.

"They are keyed to kind of the doors that the Supreme Court left open in the Trump v. Barbara decision," Forero told The Center Square. "Basically, it's all keyed to this idea that the children of enemy invaders are not entitled to automatic birthright citizenship."

The administration's revised legal theory seeks to categorize illegal aliens and individuals engaging in organized birth fraud under this principle. Still, Forero emphasized that executive action alone is only a partial stopgap.

"Really, at the end of the day, what we think here at FAIR is that this fix requires more than just executive action," Forero explained. "It requires potential legislation, and obviously, the ultimate solution would be to pass a constitutional amendment to fix the misreading of the 14th Amendment."

While the legal battle plays out, California Attorney General Rob Bonta has described Trump’s executive orders as "unconscionable."

Yet Forero maintains that reforming birthright citizenship is fundamentally about protecting public resources and national interests. Beyond the $150.7 billion annual taxpayer impact, Forero pointed to a growing national security threat: foreign adversaries taking advantage of domestic citizenship rules.

"We have this opening for foreign nationals from places like China who are essentially farming U.S. citizenship," Forero warned. "You have U.S.-born individuals who are then actually living their entire lives back in China under the Chinese Communist Party, which has clearly adversarial interests against the United States. So it's a national security concern as well."

Forero highlighted that birth tourism increasingly manifests through commercial surrogacy, bypassing physical travel entirely.

"Wealthy foreign nationals increasingly hire American surrogates so their biological children are born on U.S. soil and acquire citizenship automatically — bypassing even the need for the mother to travel," Forero said.

According to information posted online by the State Department, law firms, surrogacy groups and fertility centers, a child born on U.S. soil through a gestational surrogate is considered a U.S. citizen regardless of foreign surrogacy arrangements. Official guidelines in the State Department’s Foreign Affairs Manual stipulate that "children born in the United States acquire U.S. citizenship at birth regardless of the use of Assisted Reproductive Technology (ART) and/or surrogacy."

Official state-by-state rankings for birth tourism do not exist because federal agencies like the Centers for Disease Control and Prevention do not track tourist-visa births by location. While CDC data recorded 9,576 births to mothers listing foreign addresses in 2024, analysts consider this a significant undercount due to temporary domestic addresses. The Center for Immigration Studies  estimates actual national tourist births fall between 20,000 and 26,000 annually. Separate estimates from FAIR and CIS indicate an additional 225,000 to 250,000 children are born to undocumented mothers each year.

According to Forero, organized birth-tourism networks remain concentrated in key regions:

• California: The state functions as the primary hub for wealthy Chinese clientele through high-end "maternity-hotel" schemes charging up to $100,000. California remains the only state to face major federal prosecution of these networks, including 2019 indictments against 19 individuals linked to companies such as You Win USA, Star Baby Care and USA Happy Baby. FAIR research indicates Chinese nationals account for over 40% of the U.S. international commercial surrogacy market.

• New York: A Turkish-language scheme across seven Long Island birth houses resulted in over 100 births, $2.1 million in Medicaid fraud and a 27-month prison sentence for the organizer, according to FAIR.

• Florida: A hub for Russian and Eastern European clients centered in Sunny Isles Beach. Prominent operator Miami Mama reportedly closed following a 2020 State Department rule targeting tourist visas, FAIR noted.

• Northern Mariana Islands: Tourist births spiked to 582 in 2018 (nearly half the U.S. territory's total births) due to a 45-day visa waiver for Chinese nationals. After authorities shortened the visa-free stay to 14 days, tourist births plummeted to 58 in 2024 and 47 in 2025, according to FAIR.

Because cross-border surrogacy remains largely legal and operates in a regulatory gray area, federal authorities have limited tools to police alleged abuses or the public benefit eligibility tied to dependents born with U.S. citizenship, according to Forero.

"You have the unintended consequences of having broad citizenship rules," Forero told The Center Square. "States and Congress need to take a long, hard look at what the rules around surrogacy and cross-border surrogacy specifically need to be and what reforms are necessary."

In addition to research and investigative work on birth tourism, FAIR actively engages in strategic litigation surrounding state immigration policies, including representing 15 New York sheriffs currently challenging New York's sanctuary laws.

Ultimately, Forero said, he views tightening these statutory and constitutional loopholes as vital for the country. "It would be a win for the American people, which is what we should all be focused on from a policy perspective."