Medicaid Funding for Circumcision

The following states do NOT pay for the full cost of Medicaid circumcision:

Arizona, California, Florida, Idaho, Louisiana, Maine, Minnesota, Mississippi, Montana, Nevada, North Carolina, North Dakota, Oregon, South Carolina, Utah, and Washington.

If you live in a different state, please write to your state Medicaid Director and ask them to discontinue funding for Medicaid circumcisions. See sample letter below. Let us know what happens and if you need support.

 

 

SAMPLE LETTER

Dear Medicaid Director:

I’m writing to urge you to discontinue funding for Medicaid circumcisions. As you know, circumcision position statements have been published by the American Medical Association and the American Academy of Pediatrics, as well as medical organizations in other English-speaking countries. No national medical organization in the world recommends circumcision.

In the newborn period, there are virtually no medical indications for circumcision. The foreskin is a natural, healthy, functional body part. Normal conditions in infants and children, like a tight or long foreskin (sometimes mistakenly called phimosis), are not valid medical reasons for circumcision in minors. Legitimate medical reasons for circumcision (such as frostbite, gangrene, or cancer) are rare, and are not likely to be present in newborns.

Signs of the growing criticism about this cultural practice include the fact that a significant proportion of doctors refuses to perform non-therapeutic circumcision, some insurance companies do not cover it, and an organization exists called Doctors Opposing Circumcision.

In addition, Medicaid regulations require that services are medically necessary. Since non-therapeutic circumcision is not medically necessary, funding it is not in conformance with the regulation. We note that the burden of proof for medical necessity is on those who provide the service, not on those who question the policy. Consequently, eighteen states do not pay for elective Medicaid circumcisions.

In addition to the health implications and regulations, there are economic reasons for discontinuing funding for circumcisions. Including additional hospital stay for circumcision and circumcision complications and repairs, the total annual cost of Medicaid circumcisions is a few million dollars per state, and over $11,000,000 per state when additional lifetime costs are included. This money could be used to reduce the deficit or fund other health services that have recognized benefits.

In view of these concerns, I urge you to reconsider Medicaid funding of non-therapeutic circumcisions. Thank you for your consideration of this matter, and I look forward to your response.

Very truly yours,