Why does insurance cover infant circumcision in the hospital but not by a mohel, a Jewish ritual circumciser? After all, it’s the same result, right?

New Hampshire’s House Bill 94 is currently under consideration, another attempt to stop covering routine infant circumcision under the state’s Medicaid program, after a similar bill narrowly failed to pass last year.

You might be thinking there’s a difference between medical procedures and religious or cosmetic ones. But what’s responsible for this difference?

Perhaps it’s that medical procedures treat or prevent disease and religious or cosmetic ones don’t. Or that medical procedures are necessary while others are merely optional. But the picture is far more complicated.

Women have a one in eight chance of developing breast cancer in their lifetime, a risk that could be virtually eliminated by removing the female breast buds at birth. After all, babies can be bottle-fed. Yet no one suggests this.

Meanwhile, medical interventions embraced by one generation of doctors are often later deemed overutilized, unnecessary, or even ridiculous. Tonsillectomies, episiotomies, C-sections, electroshock therapy and ear tubes were all the rage at various times, but now have far more judicious applications. As late as the 1960s, lobotomies to address psychiatric problems were still a thing.

Medicalized circumcision in America got its foothold in the Victorian Era, as a cure for the “disease” of childhood masturbation. In many countries, such as the United Kingdom, routine circumcision isn’t part of the medical system.

The history of the medicalization of Jewish circumcision is equally fascinating. Those intrigued by this and related topics might wish to check out The Bruchim Podcast, which is launching its second season this week.

So why is routine circumcision covered by Medicaid in New Hampshire and some other states, but not uniformly? That’s a complicated story. But it’s not because circumcision really prevents disease; it’s because people are attached to the custom for reasons other than, or not just because, they think it prevents disease.

Which brings me back to my initial question: why isn’t Medicaid covering religious circumcision? It’s all or nothing: if routine circumcision is important, it should be covered in any context, and if not then maybe it’s time to reevaluate why it’s ever being covered.