NH reps table bill to strike circumcision benefits from Medicaid

After a half-hour of debate over circumcision, the NH House voted 188-187 on Thursday to table, or remove from further consideration, a bill that would end Medicaid payments for the elective procedure frequently done on newborn boys.

It would have still allowed it if a doctor deemed it medically necessary.

Rep. Joe Schapiro, D-Keene, is a member of the House Health, Human Services and Elderly Affairs Committee, which recommended March 6, 14-6, in favor of HB 1683.

He opposed the bill.

“Of all the things that I thought I never would do before I joined the Legislature, making a speech about circumcision to 400 of my peers probably tops the list,” he observed.

Currently, the New Hampshire Medicaid system pays for the costs of the procedure at birth.

“It is not considered cosmetic because there is ample research showing potential medical benefits such as reduction in penile cancers and reduced rates of HIV transmission,” he said.

A 2012 American Academy of Pediatrics policy statement says the potential benefits, including reduction of sexually transmitted diseases, outweigh risks of elective circumcision for newborn boys.

"Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns," the statement said.

Schapiro acknowledged that routine circumcision is not a medically required procedure.

“It is a choice, a parental choice, and I am here today to ask you not to take that parental choice, that parental prerogative, dare I say that parental right, away,” Schapiro said.

He said health care decisions like this shouldn’t be the province of the state Legislature, but instead should be left to families and their doctors.

"Passage of this bill will allow wealthy people, or people with private health insurance to make a choice about circumcision unencumbered by financial concerns, while low-income Granite Staters, including low-income Muslim and Jewish Granite Staters will have to consider the consequences of their decision,” he said.

More from this section

See how popular pumpkin spice is in New Hampshire

'Succession' star arrested in Moultonborough, charged with DUI

Many Muslims and Jewish people have circumcisions performed on their boys for religious reasons.

A fiscal note on HB 1683 said the state would save about $90,000 per year if it didn’t pay for newborn circumcisions. Medicaid systems in 16 states don’t cover the procedure, according to the Boston-based nonprofit Circumcision Resource Center.

Rep. Emily Phillips, R-Fremont, spoke in favor of the bill.

She said Medicaid funds should be reserved for medically necessary procedures, not elective surgery such as circumcision.

“Social, cultural, religious and ethnic traditions are the primary factors and not medical ones that parents cite when making the decision to circumcise their newborn sons,” Phillips said.

“Circumcision performed at parental request is something other than medicine and it cannot stand up to objective budget scrutiny because it cannot meet Medicaid’s criteria of medically necessary.”

Phillips said declining rates of infant circumcision underline the lack of medical necessity for the procedure.

“Foreskin is not a birth defect and nobody wants less penis,” Phillips said.

The national rate for circumcising newborn boys has dropped to below 60%, according to the U.S. Centers for Disease Control and Prevention.

•••

Rick Green can be reached at RGreen@KeeneSentinel.com or 603-355-8567.

These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.