WA SB6191

Prohibits Washington Medicaid from covering gender-affirming medical interventions for individuals under age 18, even with a gender dysphoria diagnosis

Excluded services for minors include breast augmentation procedures, breast reductions, breast implants, sex reassignment surgery, puberty suppression therapy, and hormone therapy (both presurgical and postsurgical)

Amends existing law (RCW 74.09.675) that currently requires Medicaid coverage of gender-affirming care without age restrictions and prohibits categorical exclusions of such treatment

Retains existing protections for adults, including prohibitions on discrimination based on gender identity, bans on blanket cosmetic exclusions, and requirements for adequate provider networks for gender-affirming care

Maintains requirement that adverse benefit determinations for gender-affirming treatment must be reviewed by a health care provider experienced in prescribing such treatment