Senate committee votes to restore Medicaid funds for circumcision

By Diane Carman

Despite the spirited testimony of seven opponents to routine circumcision, the Senate Health and Human Services Committee Thursday voted 6 to 3 to restore Medicaid funding for the procedure.

A change in the long bill, the budget document developed by the Joint Budget Committee, dropped funding for the procedure last year, making Colorado one of 18 states to defund circumcision under Medicaid. Senate Bill 90, introduced by Sen. Joyce Foster, D-Denver, would restore the funding, estimated at $186,500 annually.

Foster told the committee that the bill was about disease prevention, fairness and social justice.

More important, she said, is that its about parental choice.

Dr. Jeremiah Bartley, a Brighton obstetrician-gynecologist, cited studies suggesting that circumcision reduces the risk of HIV infections.

AIDS is a life sentence, he said, adding that any way that the disease can be prevented should be pursued.

Scot Anderson, a physicist who opposes funding for routine circumcision, challenged Bartleys assertion that circumcision reduces the rate of HIV transmission in this country, saying that the studies Bartley cited referred to HIV rates in Africa where myriad other factors affect HIV transmission.

In this country weve been circumcising children longer than 60 years and we have the highest rate of HIV of any developed country in the world, Anderson said.

The United States and Europe provide a huge database on the relationship between HIV and circumcision, he said. About 80 percent of European men are not circumcised while 80 percent of American men are and Europes HIV infection rate is a fraction of that of the U.S.

Anderson also disputed the estimated cost of circumcision to the state, saying that, based on average costs and the number of procedures reported in hospitals across the state, the likely cost to taxpayers was closer to $4 million annually.

Sen. Shawn Mitchell, R-Broomfield, questioned proponents about spending scarce Medicaid funds on a procedure that is not considered medically necessary and isnt recommended by the American Academy of Pediatrics. Should the money for the poor go to more pressing medical needs?

Sen. Irene Aguilar, D-Denver, compared the procedure to routine mammograms for women under 50 and tests for Prostate-Specific Antigens both of which are not recommended by medical organizations but are covered under Medicaid.

Gillian Longley, a registered nurse in Louisville, described routine circumcision of newborn boys as elective, non-therapeutic, cosmetic surgery.

It is neither medically necessary nor cost-effective, she said.

Mark Filbert challenged the assertion that public funding for circumcisions was a matter of social justice.

Nobody has said anything about the choice of the person on whom this is done, he said. I very much resent that this decision was made for me. I dont think state money should be used to potentially violate the individual human rights of men.

Senators Ellen Roberts, R-Durango; Jean White, R-Hayden; and Kevin Lundberg, R-Berthoud, voted against restoring the funding. Senators Jeanne Nicholson, D-Black Hawk; Betty Boyd, D-Lakewood; Linda Newell, D-Littleton; Mitchell; Aguilar; and Foster voted for the bill.

SB-90 will move to the Appropriations Committee for further consideration.