The bill would create a new law by adding three sections to chapter 74.09 RCW titled the "medically necessary fertility preservation act." It requires the authority, beginning January 1, 2027, to provide coverage for all expenses related to "standard fertility preservation services" for Medicaid enrollees under chapter 74.09 RCW. "Standard fertility preservation services" are defined in the bill as medically necessary procedures to preserve fertility that align with established medical practices or professional guidelines published by the American Society of Clinical Oncology or the American Society for Reproductive Medicine for a person who has a medical condition or is expected to undergo treatment recognized to risk impairment to fertility. The bill also prohibits the authority and Medicaid managed care organizations from applying exclusions, limitations, or other restrictions to fertility medications that differ from other prescription medications and from imposing benefit maximums, waiting periods, or other limitations on coverage for these services that differ from non-infertility-related services. This is a substantive coverage requirement and procedural change to Medicaid benefit rules rather than a criminal or penalty change. Important context is missing from the extracted facts: the identity or statutory definition of "the authority," any definition of "Medicaid managed care organization," specific administrative implementation or payment methods, oversight or enforcement mechanisms, the precise RCW section number added, fiscal impact or rulemaking provisions. The bill was read for the first time on January 16, 2026.

Starting January 1, 2027, Medicaid enrollees who face a medically recognized risk of fertility loss because of illness or treatment would be able to have all expenses for fertility preservation services covered when those services follow established ASCO or ASRM guidance. In practice, people undergoing surgery, chemotherapy, radiation, or other treatments that can impair fertility would likely see reduced out‑of‑pocket costs and greater access to procedures and medications to preserve fertility, and fertility clinics could expect more Medicaid patients and reimbursement claims. Medicaid program administrators (referred to here as "the authority") and Medicaid managed care organizations would have to change coverage rules and pharmacy policies so fertility medications and preservation services are treated the same as other covered medications and services; that will increase administrative work and likely raise Medicaid program and MCO costs, though the bill does not specify payment rates, oversight, or how much costs will rise. It is unclear which specific agency is meant by "the authority" and the text does not provide details on implementation, reimbursement methodology, fiscal impact, or enforcement.