West Virginia Attorney General Patrick Morrisey has requested the U.S. Supreme Court to review a federal appeals court decision that ruled the state's exclusion of gender-affirming surgeries from Medicaid coverage is unconstitutional. The Fourth Circuit Court found that such exclusions constitute discrimination based on sex and gender identity. Morrisey argues that the state should have the discretion to prioritize its limited resources for more commonly needed medical treatments, emphasizing the high costs associated with sex-reassignment surgeries. He maintains that the state's Medicaid program must make tough decisions about care coverage. This appeal marks Morrisey's second recent challenge regarding transgender rights, as he also contests a law restricting transgender athletes in sports. The Supreme Court's decision on whether to take the case remains uncertain, but the Attorney General is advocating for West Virginia's policies to be upheld.