Medicaid no longer provides
funding for circumcision in
the following states:
4. North Dakota
9. North Carolina
17. Who will be next?
|Medicaid to drop practice
Missouri coverage will no longer include routine circumcisions.
By STEVIE ST. JOHN, Missourian staff
July 25, 2002
Beginning next month, Missouri Medicaid will no longer pay for
male infant circumcisions. The decision to no longer fund the
procedure will save state coffers about $260,000 a year.
Missouri Medicaid officials were looking for ways to reduce costs
and considered professional recommendations regarding routine
circumcision, said Greg Vadner, director of the Missouri Division of
Beginning Thursday, Missouri Medicaid will no longer cover routine
male infant circumcisions, he said. Circumcisions that are medically
necessary, such as in case of infection, will still be covered.
By not covering routine circumcisions, in which the foreskin is
removed from the penis, Missouri Medicaid expects to save
$262,103 a year, he said.
“We think this is a change that is reasonable . . . that follows
established medical guidelines,”
Missouri Medicaid listened to input from Doctors Opposing
Circumcision, the American Academy of
Pediatrics and individual doctors before making the decision, he
Vickie Greenlaw, reimbursement assistant for the division of
urology at MU Health Care, said there
is a $210 doctor’s fee and a small instrument use fee for each
Dr. Lynn Teague, a pediatric urologist with MU Health Care,
performs one or two circumcisions per
week. However, he said, the circumcisions he performs are mostly
procedures that are necessary
because of congenital problems. Teague said he does not believe
routine circumcisions are
medically necessary and counsels parents against it.
“I think (Missouri) Medicaid did the right thing,” he said.
Circumcision was thought to be a treatment for ailments including
epilepsy and alcoholism around
1900, he said, and became the norm. He said babies are
circumcised “to look like dad.”
“I think it’s a cultural thing rather than a medical thing,” he said.
Circumcision does decrease the risk of infections for the first few
months of life, he said, but does
not seem to make much difference later. He said that studies
suggest an uncircumcised man who
practiced proper hygiene would not be at an increased risk for
Dr. George Denniston, president of the Seattle, Wash.-based
international organization Doctors
Opposing Circumcision, said circumcision is harmful. Foreskin
protects glands, covers the shaft of
the penis when it is erect and has nerve endings related to sexual
pleasure, he said in a phone
interview from the Seattle Doctors Opposing Circumcision office.
Dr. Jack Swanson, a pediatrician in Ames, Iowa, served on the
American Academy of Pediatrics
task force on circumcision in 1999, when the academy’s
statement on circumcision was last
revised. In a phone interview, he said uncircumcised men have a
slightly increased risk of infection
in the first year of life and a slightly increased lifetime risk for
But he said these occurrences are not frequent enough to justify
every male being circumcised as
a preventative medical measure.
He said that he tells his patients it is OK to have their baby
circumcised but that they should
understand that they do not need to.
“It’s got to be a personal choice about what the parents think is
right,” he said.