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A spokesman for the Rhode Island Department of Health said the agency does not track circumcision rates and therefore he could not comment. Representatives at Iowa Hospital Association were surprised to learn that their state has an 82% circumcision rate, among the highest in the country.
Pete Wertheim, a spokesman for Arizona Hospital and Healthcare Association, said his state has long had a low circumcision rate. But Wertheim said a “driving factor” in pushing the figure down further could be that the state discontinued Medicaid coverage for circumcision in July 2002.
Circumcision rates are 24% higher in states where Medicaid covers the procedure, according to a brief produced by the Health & Human Services Department’s Healthcare Cost & Utilization Project.
In Arizona in 2001, a year before the Medicaid provision was cut, 41% of boys born in the state were circumcised in a hospital. Two years later, that number had fallen to 26%.
Wertheim said Arizona cut Medicaid coverage for circumcision at a time when the state was trying to trim $1 billion from its budget. Cutting circumcision saved about $400,000 per year, he said.
If cost had been a deciding factor for Arizona, there is new evidence that circumcision might actually save a great deal of money. A new study, published August 20 in the Archives of Pediatrics & Adolescent Medicine, warns that cutting funding for circumcision may be more expensive in the long-run because circumcision reduces the prevalence of a range of diseases, including urinary tract infections, syphilis, herpes, penile cancer and HIV.
Health experts and economists at Johns Hopkins University School of Medicine warned that if circumcision rates in the United States. fall to the same level as in Europe, it could add more than $4 billion in health care costs over a decade.
As the study’s authors called on states to rethink their decision on cutting Medicaid funding for circumcision, the American Academy of Pediatrics was preparing to release its new guidelines on circumcision.