Medicaid funding for infant circumcision used to be available in every state, but starting with California in 1982, 18 states (Arizona, California, Colorado, Florida, Idaho, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Oregon, South Carolina, Utah, and Washington) had eliminated Medicaid coverage of routine (non-therapeutic) circumcision by July 2011. One study in the Midwest of the U.S. found that this had no effect on the newborn circumcision rate but it did affect the demand for circumcision at a later time. Another study, published in early 2009, found a difference in the neonatal male circumcision rate of 24% between states with and without Medicaid coverage. The study was controlled for other factors such as the percentage of Hispanic patients. Other studies have shown that the rise of immigrants from East Asia, Southeast Asian, South Asia and Hispanic South American countries are a large factor in why the rates continue to drop in the US.