Cook County Board President Toni Preckwinkle Releases FY2027 Preliminary Budget Forecast

After Years of Strengthening Its Finances, Cook County Is Prepared to Address Budget Challenges

COOK COUNTY, IL— Cook County Board President Toni Preckwinkle today released the County’s FY2027 Preliminary Budget Forecast, highlighting how years of disciplined financial management, responsible budgeting and long-term planning have positioned Cook County to navigate a period of significant economic and fiscal uncertainty. Through strategic investments, strengthened reserves, pension stabilization and multiple credit rating upgrades, the County has built a strong fiscal foundation that will help it address unprecedented pressures stemming from a recent court ruling, substantial federal reductions in health care funding enacted by the Trump administration, economic strain from the conflict in Iran and general inflationary pressures.

As a result, while Cook County enters this period from a position of fiscal strength, the FY2027 Preliminary Budget Forecast identifies significant external pressures that will require careful planning and difficult decisions. The forecast projects a budget gap of $550.7 million across the County’s General and Health Funds in FY2027. Absent a court-ordered restriction on tax revenue use of $258.0 million and an expected $138.0 million fallout of federal changes in the One Big Beautiful Bill Act (OBBBA) impacting the hospital system, the FY2027 gap would be a significantly smaller $154.6 million.  

“By implementing budget best practices, spending taxpayer dollars responsibly and taking a strategic approach to our finances, the County has created a strong fiscal foundation as it navigates unpredictability and instability,” said President Preckwinkle. “We have done things the right way when it comes to budgeting: we use best practices, we spend responsibility, we pay down legacy obligations, we plan ahead and set aside money for emergencies, but the County is not immune to extraordinary outside factors like federal action or court rulings.”

The preliminary forecast report presents a mid-year projection of year-end revenues and expenses for FY2026. The report also presents an initial forecast for FY2027 revenues and expenses for the General Fund and Health Enterprise Fund, the County’s two major operating funds.

General Fund Overview of FY2026 Year-End and FY2027 Preliminary Forecast

For the FY2026 year-end, the County is projecting a surplus of $283 million in the General Fund. Several factors contributed to this positive variance including a one-time cigarette tax settlement, higher-than-anticipated Sales Tax Revenue and a mid-year budgetary holdback to reduce costs.

In FY2027, the General Fund is expected to have a budget gap of $336.0 million. Total base revenues are expected to increase driven primarily by a $147.2 million projected uptick in Sales Tax revenues while expenses are forecasted to increase principally due to a court ruling restricting the use of transportation related taxes causing a structural budget deficit of $258.0 million, scheduled increases in personnel costs and rising health care costs. 

Health Fund Overview of FY2026 Year-End and FY2027 Preliminary Forecast

Even though year-end revenues are expected to be $315.9 million higher than budgeted, Cook County Health projects a $42.8 million gap for the FY2026 year-end, driven largely by increase in charity care services.  

In FY2027, the Health Enterprise Fund is expected to have a budget gap of $214.7 million.

Revenues are expected to decline by $486.5 million due to a significant expected decrease in CountyCare membership caused by sweeping federal cuts and Medicare eligibility restrictions. While payroll and pharmaceutical expenses are projected to grow, overall expenses are projected to be lower than FY2026 budget by $271.9 million due to reduced Managed Care Claim expenses.  

Preckwinkle singled out the devastating impact cuts to health care are expected have on the County, denouncing federal action that increased national debt while taking away health insurance for millions of Americans to subsidize tax breaks for the country’s highest earners.

“Despite federal actions that will reduce access to health care for many residents and create significant financial challenges for safety-net providers, Cook County remains deeply dedicated to responsible budgeting and protecting the services people rely on,” said President Preckwinkle. “We have experienced large shortfalls in the past as well as dramatic losses of revenue, a global pandemic, and a lack of state budget for two years. Each of those experiences strengthened our financial management and prepared us for this moment. I am confident that with disciplined planning, sound fiscal stewardship and a continued focus on our residents, Cook County will successfully navigate these challenges.”  

A public hearing on the preliminary forecast will take place at 5:30 p.m. on July 9. Residents will have an opportunity to provide testimony and engage directly with the President’s office on their budget priorities. The President’s office will livestream the public hearing.

Beginning June 18, residents can visit the County’s website at www.cookcountyil.gov/Budget to view the preliminary forecast.

Residents will also be able to submit budget questions at  www.cookcountyil.gov/service/submit-budget-questions.