A penile implant is not a penile enhancement surgery any more than a knee implant is "knee enhancement" surgery. It is a last resort treatment for intractable impotence. The entire point of medical care is restore impaired body functions to as near normal as possible. Impotence is often due to the side effects of critically necessary medications , injury and the disease process elsewhere in the body. Telling someone the state has decided they will never be allowed to have even a semblance of a normal sex life again is beyond cruel given it plays such a major role in a person's quality of life. Surgical repair to allow a woman suffering from injury or disease to regain painfree intercourse has always been covered.