Cook County Unveils $9.69 Billion Budget, Absorbs $550M Deficit Without Tax Hikes (Cook County, IL) — Cook County Board President Toni Preckwinkle unveiled a proposed $9.69 billion Executive Budget for Fiscal Year 2027 on Thursday, closing a $550 million budget gap without increasing taxes, laying off county staff, or cutting essential services.
County officials attributed the balanced proposal to 15 years of fiscal discipline, which allowed local government to absorb severe external financial shocks, including federal funding rollbacks and court-ordered revenue freezes.
“That foundation is what allowed us to weather extraordinary external pressures this year, including a court ruling that froze hundreds of millions of dollars in transportation revenue and deep cuts in federal health care funding from the Trump administration,” Preckwinkle said during her address.
External Pressures Drive $550 Million Gap
In June, preliminary financial forecasts projected a $550.7 million gap across Cook County’s General and Health Funds for FY2027.
According to budget officials, more than 70% of that deficit was driven by outside factors:
- Court-Ordered Freeze: A pending legal restriction blocked $258 million in designated transportation tax revenues.
- Federal Healthcare Cuts: An estimated $138 million reduction stemmed from federal policy changes under the One Big Beautiful Bill Act (OBBBA) impacting county hospital operations.
Without these two external disruptions, the county’s baseline deficit would have stood at $154.6 million.
To close the shortfall, county leadership deployed a multi-pronged financial strategy. The county utilized $88 million in investment returns, $93 million in higher-than-expected revenues, $46 million from vacancy management, $35 million in departmental budget cuts, and $18 million in reserve funds. An additional $61.2 million was redirected from long-term ARPA program allocations to support general operations.
Health System Absorbs Cuts Amid Surging Uninsured Rates
Public health and public safety represent 72.7% of Cook County’s overall operating expenditure.
Cook County Health (CCH) faced significant headwinds due to shifting federal policies. Recent changes to federal Medicaid eligibility are projected to strip coverage from roughly 330,000 Illinois residents, while the expiration of enhanced marketplace subsidies left another 92,000 without commercial insurance in FY2026.
As a result, CCH expects its uncompensated care load to reach 30% in FY2027—more than double its 2023 level of 13%—with charity care costs soaring to $485 million.
To mitigate these losses, CCH reduced operational expenses by $314 million through cuts to external agency staffing, contracted services, and supplies. However, to avoid clinical layoffs and service cutbacks, Cook County allocated an additional $40 million in local tax support to CCH, raising direct county backing to $208 million. CCH’s total proposed budget for FY2027 is $4.7 billion, down $439 million from FY2026.
“The massive scale of the federal funding reductions exceeds what we can do from an efficiency perspective alone,” said Cook County Health CEO Dr. Erik Mikaitis. “We are grateful for the additional support from Cook County government, which will be essential to protecting access to critical health programs.”
Public Safety Investments Yield Results
The proposed budget allocates $1.67 billion to the public safety system, representing 60.6% of the General Fund, a $150 million (10%) increase over the FY2026 adopted budget.
Preckwinkle pointed to significant safety gains across the region, noting that gun homicides in Cook County have decreased by 50% since spiking in 2021. Officials linked the improvement to a combined $350 million multi-jurisdictional investment in community violence intervention, of which Cook County contributed $110 million.
Long-Term Outlook and Public Engagement
The county’s overall headcount remains flat compared to last year, maintaining an overall 8% workforce reduction since Preckwinkle took office. Over the past five years, Cook County has earned six bond rating upgrades and raised its pension funding level from 56% to 66%.
The full FY2027 Executive Budget Recommendation, along with an interactive financial portal and a public question submission form, is now live on the Cook County website. Hearings and formal deliberations by the Cook County Board of Commissioners will follow before final adoption.
Budget Materials Available Online
All FY2027 budget information is now posted to the Cook County website, allowing the public to review documents and engage with the President’s Office directly. An interactive budget website is available, providing historic financial data and detailed budget information.
Starting today, residents can also now submit budget questions here.
View the Budget at a Glance document here.
Read President Preckwinkle’s full budget address here.
Watch President Preckwinkle’s full budget address here.
Cook County Unveils $9.69 Billion Budget, Absorbs $550M Deficit Without Tax Hikes
