SB12-090, Restoring Male Circumcision Under Medicaid

SB 12-090

Restoring Coverage for Circumcision of Males under Medicaid

Sen.(s) Foster, Aguilar, Bacon, Boyd, Carroll, Giron, Guzman, Heath, Hudak, Johnston,  Morse, Newell, Nicholson, Schwartz, Williams S., and Rep. Court

Staff researcher:  Amber Widgery

What the Bill Does:
SB 12-090 reinstates male circumcision into the procedures covered by Medicaid, and forbids the state board from removing circumcision in the future from the list of procedures eligible for Medicaid reimbursement.

Colorado Context:
Previously Colorado offered circumcision as a part of Medicaid until last year when it was cut to help bring the budget into balance. It was estimated that the cut would save the general fund $186,500 overall.

National Context:
Other states have dropped circumcision from Medicaid coverage (17 at the moment). Santa Monica and San Francisco have even tried to ban the practice altogether as genital mutilation following the coverage received by female genital mutilation. Massachusetts proposed legislation last year to ban the practice as well, but the bill never made it out of committee. Most states that no longer cover the practice have seen a drop overall in the rate  of circumcision. However this has not been directly linked to the lack of Medicaid coverage.

About 75% of male Americans are circumcised, compared to 30% in Canada and only 6% in the UK. The procedure is medically routine and safe; only 2-4% of circumcisions in adullts lead to, while the rate is only 0.2% of neonatal circumcisions. According to the World Health Organization the majority of circumcisions occur not for health reasons, but instead for cultural or religious reasons.  Nonetheless, the health advantages are numerous, including:

• Reduction of the spread of HIV/AIDs
• Lower prevalence of STD’s specifically ulcerative diseases like syphilis
• Prevention of  phimosis, paraphimosis, and inflammation of the foreskin
• Reduced chance of UTI (mostly within the first year)
• Reduced HPV and thus cervical cancer in women who are sexually active with circumcised men
• Lower risk of penile cancer

The risks, though minimal, include the possibility of post-operative Infection, haematoma (blood clot under skin), meatitis (swelling of the urethra), and reactions to anesthetics used during the procedure, leading in very rare instances to penile mutilation and even death.

Provisions of the Bill:
Adds a part (3) to Title 25.5 Article 5 Section 102, reinstating male circumcision when performed by a physician as a procedures covered by Medicaid under paragraph (d) of part (1).

• Prohibits the state board from removing circumcision from the list of Medicaid-eligible procedures in the future.

Fiscal Impact: The Colorado Legislative Council staff has not yet prepared a fiscal note.  Based on the savings estimated last year by eliminating circumcision from Medicaid eligibility, it can be assumed that about $180,000 will have to be added to the budget or taken from some other allocation to avoid increasing the cost to the state if the bill is enacted.