Cook County’s budget gap is projected to rise to $550 million heading into next year, the highest figure since Board President Toni Preckwinkle took office in 2011.
Her financial team blamed fallout from a costly lawsuit the county lost over its infrastructure spending, growing payroll and benefit costs awarded in previous years and federal cuts to healthcare coverage.
“This is going to be a really tough budget year, but we begin it from a position of strength,” Preckwinkle told reporters Wednesday. “Over the last 15 years, we’ve balanced our budgets, strengthened reserves, improved our bond ratings … and we’ve made some real progress on our pension funding. But even strong internal fiscal management can’t shield us from external events — court decisions, federal policy changes and rising costs across the economy.”
While beating the $487 million deficit record in 2011, next year’s figure represents a much smaller slice of the county’s budget this time around. That 2011 hole was equal to about 21% of the county’s budget. This year’s gap represents about 7%, budget director Kanako Ishida Musselwhite said.
The deficit announcement happens every summer, and the shortfall can shrink if the county makes mid-year changes to its spending plan.
Preckwinkle, who’s running for a fifth term in November, did not offer concrete cuts or revenues the county was exploring, but noted she and the county board have passed multiple budgets in recent years without layoffs, fresh taxes or fees.
The county is exploring “a variety of belt-tightening measures,” she said, but has no current plans for a hiring freeze.
She said she would only turn to new taxes or fees “as a last resort.”
“So we’re going to be looking at cost savings and efficiencies before we consider any new taxes,” Preckwinkle said. “Our goal is always to balance the budget without asking more from our taxpayers.”
More than half of next year’s deficit, $258 million, was created when the county lost a lawsuit related to the Safe Roads Amendment, budget officials said.
Back in January, a Cook County Circuit Court judge ruled that the county’s use of hundreds of millions in transportation tax money during the 2023 fiscal year violated the state constitutional amendment designed to ensure tax revenues collected from gas, parking lots, garages and car purchases were only spent on infrastructure projects.
The county argued it should have been able to spend it on other expenses tied to enforcing the rules of the road. It had used that money to pad the budgets of the county sheriff, state’s attorney, public defender and circuit court clerk. But the judge sided with the Illinois Road and Transportation Builders Association, a trade group representing construction, design and maintenance firms, which originally sued the county over its spending practices in 2018.
That money didn’t disappear, but must be spent on transportation projects going forward.
Commissioners previously OK’d taking $179 million from the county’s reserves for this year’s budget to pay for public safety expenses that were no longer allowable under the amendment. The county is awaiting the judge’s final order, and plans to appeal.
Long-anticipated federal cuts to healthcare will hit in 2027, budget officials said. That includes the impact of President Donald Trump’s One Big Beautiful Bill, which cut Medicaid eligibility. That means thousands fewer people enrolled in the county’s Medicaid insurance plan, CountyCare, and a cut to covered costs for Medicaid patients that come to the county’s hospitals and clinics.
It also means more uninsured patients will come to the county’s door with little or no ability to pay. “These self-pay patients are much less likely to pay their bills,” Dean Constantinou, the county’s deputy chief financial officer, said Wednesday. In all, Cook County Health is expecting “uncompensated care” costs to rise by $100 million, to about $470 million.
Between those cuts and increasing payroll costs, the county health fund gap is projected to be $214 million. Cook County Health officials said they would work to reduce overtime costs and spending on outside agencies, which help staff hospitals and clinics.
Between the health and general funds, payroll costs are projected to climb by $176 million. That’s in part because the county awarded 3.5% retroactive annual pay increases dating back to 2021 to its largely union workforce during the pandemic, then gave 5% raises in 2025. The county said those “were necessary to keep compensation competitive amid inflation.”
Pension and health contribution costs are expected to rise, too.
Between its two major funds covering general county functions and its health system, Cook County is still expected to end this year with a surplus of about $240 million.
That might be a surprising figure given the deficit, Ishida Musselwhite said, but it comes down to two unexpected cash infusions. The first is a $115 million tobacco tax settlement the county recently won against Sam’s Club. The second is $122.7 million in higher sales tax receipts than expected, thanks in part to tariffs driving up the cost of goods across the board.
Because that year-end surplus is considered “one-time,” county policy is not to turn around and spend it to plug the following year’s budgets, but save it for future one-time projects or expenses. That surplus will be added to the county’s reserve funds, which stand at about $1.4 billion, Constantinou said.
Preckwinkle won’t formally announce her budget proposal until the fall.
