(The Center Square) – With tens of thousands of King County residents at risk of becoming uninsured, King County Councilmember Claudia Balducci is proposing collaboration with health care providers to strategize mitigation efforts.
According to county officials, 75,000 to 100,000 King County residents are at risk of losing Medicaid coverage starting next year with the passage of President Donald Trump’s One Big Beautiful Bill Act. The act limits Medicaid eligibility requirements and cuts federal spending on the program.
Federal officials have pointed to ballooning costs and inefficiencies in the Medicaid system. In 2024, roughly 1.2 million people were enrolled in Medicaid or CHIP across multiple states, and another 1.6 million people were enrolled in both Medicaid and subsidized Affordable Care Act exchange plans. Erroneous enrollments have cost the federal government and taxpayers approximately $14 billion per year in duplicate payments, as previously reported by The Center Square.
King County Chief Operating Officer Dwight Dively flagged cuts to Medicaid as one of three areas where county programs are at risk of significant impacts from the federal government’s budget. The other two areas are permanent supportive housing and emergency management, which The Center Square previously reported on.
During a Committee of the Whole meeting on Tuesday, Balducci pitched the council take on a leadership role in convening a “health care stabilization summit” to bring together state and local leaders with major healthcare providers and patient advocates to come up with a strategy.
Balducci added that King County has seen success in the past with this strategy. The county previously partnered with organizations to coordinate when the Affordable Care Act went into effect and Medicaid expanded. This contributed to the county’s success in signing people up for the program and dropped its uninsured rate.
“We know we can make a difference when we focus on trying to help the people here and we work with our partners,” Balducci said during the committee meeting.
The Center Square previously reported that the county-owned Harborview Medical Center’s uninsured rate was 12% before the Affordable Care Act was enacted in 2010. It now hovers around 3%. That is expected to change as part of the One Big Beautiful Bill Act, which restricts eligibility for certain noncitizens and imposes new work requirements.
The provisions of the Big Beautiful Bill will not take effect until after the 2026 midterm elections, which Balducci described as “gross political calculation.”
Fellow Councilmember Teresa Mosqueda said a resolution is being developed for the county council to consider in October that looks at where King County can step in and increase infrastructure support, and identify ways to provide subsidies, and establish a strategy for advocating for state-level funding.
So far, King County has not had trouble receiving federal funding. According to Dively, the county continues to be able to protect existing grants and contracts with the federal government as attorneys have gradually broadened injunctions to include more services. Federal agencies have been complying with these injunctions “sometimes reluctantly,” as Dively put it.
“Once they are reminded that a court has ordered them to continue to provide the funding, they have done so, at least for King County programs,” Dively said.
Balducci’s proposal was not part of official legislation, so no action was taken on Tuesday.
