House Bill 94, or the “Children’s Body Autonomy Act,” would prohibit New Hampshire’s Medicaid program from covering circumcision unless medically necessary. (Photo by Getty Images)
A new proposal to ensure New Hampshire’s Medicaid program doesn’t pay for circumcisions unless medically necessary was approved in the state House of Representatives by a single vote Thursday.
If enacted, House Bill 94, or the “Children’s Body Autonomy Act,” would prohibit New Hampshire’s Medicaid program from covering circumcision unless medically necessary. Conditions that would make circumcision medically necessary under the bill include recurrent urinary tract infections, a neurogenic bladder, and spina bifida.
Medicaid in New Hampshire currently covers circumcision for infants, which is optional and done at parents’ request. Medicaid spent $211,433 on circumcision-related services in New Hampshire the fiscal year 2024, according to the state Department of Health and Human Services. Of that amount, $82,553 went to elective circumcisions.
A previous attempt by lawmakers to ban Medicaid coverage for such circumcisions failed last year after the House voted, 178-197, in March 2024 to kill the similar House Bill 1683.
This year’s bill, sponsored by Windham Republican Rep. Julius Soti, was approved by the House in a 184-183 vote on March 6. It will now be considered by the Senate.
Proponents of the bill argued that although circumcision is often preferred for religious or personal reasons, because it carries risk and is not medically necessary the state should not be in the business of paying for it. They also argued it diminishes sexual pleasure, which also shouldn’t be paid for by the state. Some also deemed the purported health benefits unfounded.
Opponents argued that, as it is a common practice in the U.S., it seems clear the majority of people circumcised are not traumatized by the procedure and that doctors and parents should make the decisions on circumcision, not legislators. They were also concerned it would send a negative message to the Jewish and Islamic communities in New Hampshire, for whom circumcision is an important religious practice.
The American Medical Association wrote in 2023 that “current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV.”
However, some medical organizations in other countries disagree. In a report published in 2015 and reaffirmed in 2024, the Canadian Paediatric Society doesn’t recommend routine circumcision for young boys, arguing research hasn’t clearly established medical necessity. The organization found that the decrease in the risk for illnesses like penile cancer, HIV, and urinary tract infections, which are infrequent, is comparable to the risk of complications such as pain, bleeding, or surgical mishap.
The British Medical Association wrote in 2019 that “the evidence concerning health benefit from NTMC (non-therapeutic male circumcision) is insufficient for this alone to be a justification for boys undergoing circumcision. In addition, some of the anticipated health benefits of male circumcision can be realised by other means — for example, condom use.”
Doctors Opposing Circumcision, a U.S.-based organization calling for the end of routine circumcision, notes that the U.S. is the only country globally where newborn male circumcision is commonly performed for nonreligious reasons.
Additionally, circumcision reportedly interferes with sexual function by causing lower levels of penile sensation and greater difficulty reaching orgasm, according to research compiled by Doctor’s Opposing Circumcision. However, research is still mixed, with other studies — including a 2020 Sexual Medicine study and a 2016 Nature Reviews Urology paper — finding no link between circumcision and sexual function.
These debates engulfed the New Hampshire State House as well.
“We do not remove the appendixes of infants because they might need that surgery later,” Rep. Ellen Read, a Newmarket Democrat, said on the House floor, refuting arguments that circumcision prevents some conditions. “We don’t remove the tonsils of infants. We don’t remove any healthy tissue from an infant because they might have an infection.”
Read argued the bill isn’t “an attack on Medicaid” as some might argue.
“Although I passionately support single-payer health care, I don’t support this coverage, any more than I would support any other cosmetic procedure on an 8-hour-old infant,” she said.
Rep. David Nagel, a Gilmanton Republican opposing the bill who is also a doctor, said the bill “reduces a very complex biopsycho social issue to a purely biomedical one,” arguing it doesn’t take into account the social factors that lead people to circumcision. He also noted that complications are rare and if someone medically needs circumcision later in life, it’s more expensive than if they did it as an infant before it’s medically necessary.
Support and opposition of the bill were both bipartisan.
“This bill does not ban circumcision, but simply says that the government should keep its hands off where they don’t belong,” Republican Rep. Donald McFarlane, of Orange, said. “We Americans can and should make female orgasms great again.”