Illinois Insights Special Edition: Cook County Board President Preckwinkle Releases FY2027 Proposed Budget

Cook County Board President Preckwinkle Releases FY2027 Proposed Budget

Cook County Board President Toni Preckwinkle released her proposed Fiscal Year 2027 budget. The proposal totals approximately $9.69 billion and continues the County’s approach of balancing its budget without increasing the base property tax levy. County officials emphasized fiscal stability and continued investment in core services while acknowledging growing pressures related to federal Medicaid changes, healthcare costs, public safety, and transportation funding.

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Revenue Overview

Cook County’s FY2027 revenues total $9.69 billion. The largest source is Cook County Health revenue at $4.43 billion, or 45.7% of the total, followed by sales tax revenue at $1.55 billion, or 16.0%. Property taxes contribute $832.4 million, while personal property replacement taxes and other taxes and fees generate $1.09 billion. Additional revenues include $724.6 million from grants and intergovernmental sources, $305.1 million in debt proceeds, and miscellaneous and other revenues.

The County’s two primary operating funds, the General Fund and Health Enterprise Fund, are projected to generate $7.46 billion, down $375.8 million, or 4.8%, from FY2026. A $436.4 million decline in Health Enterprise Fund revenue, attributed largely to lower CountyCare enrollment resulting from federal Medicaid eligibility changes, is partially offset by a $60.6 million, or 2.3%, increase in General Fund revenue. Excluding fund balance use, base General Fund revenue rises by $223.8 million, driven primarily by a $182.2 million increase in sales tax revenue and a $25.1 million increase in investment income.

Expenditure Overview

Countywide expenditures total $9.69 billion. Healthcare and public safety are the two largest service areas, accounting for 72.7% of the County’s $9.16 billion operating budget, with $4.78 billion allocated to healthcare and $1.89 billion to public safety.

The budget allocates $629.9 million to the County Employees’ Annuity and Benefit Fund for pension contributions and retiree healthcare costs and $290.6 million for debt service. Finance and administration, economic development, property and taxation, and administrative overhead account for another $1.58 billion. Capital spending totals $532.8 million.

Combined General Fund and Health Enterprise Fund expenditures total $7.46 billion, down $375.8 million from FY2026. Health Enterprise Fund spending declines by $436.4 million due largely to lower anticipated CountyCare enrollment and related claims, while the General Fund budget increases by $60.6 million, or 2.3%, because of higher personnel, healthcare, prescription, and debt service costs, as well as the loss of Transportation Fund credits. The proposal includes 14,492 General Fund positions, a 0.3% decrease from 14,543 in FY2026.

Key Takeaways

Balanced Budget Maintains No-Tax-Increase Approach

The proposal does not increase the County’s base property tax levy, which has remained unchanged since 1996. Property tax revenue nevertheless grows through new construction, expired incentives, and expiring TIF districts. The County also relies on revenue growth, reserve resources, and expenditure controls to maintain core services.

Cook County Health Faces Growing Medicaid Pressures

Federal Medicaid policy changes are expected to reduce CountyCare enrollment and place additional financial pressure on Cook County Health. The proposal provides an additional $40 million in County tax support to help preserve critical healthcare programs.

Uncompensated Care Continues to Increase

Cook County Health projects uncompensated and charity care to increase by approximately $100 million, reaching $485 million in FY2027. The County reports that it provides more than 40% of the uncompensated care received by Cook County residents.

Public Safety Remains a Major Spending Priority

The public safety allocation of $1.89 billion supports the County’s courts, corrections system, law enforcement, prosecution, public defense, and related justice programs. The proposal also continues investments in violence prevention, reentry services, alternatives to detention, pretrial and juvenile justice reform, and improved criminal justice data collection and coordination.

Strong Reserve Position Supports Fiscal Flexibility

The proposed budget relies on several reserve-related measures to address short-term fiscal pressures while maintaining core services. The County plans to use its ARPA Program Sustainability Reserve to maintain programs previously supported by federal pandemic-relief funding, with the goal of phasing out reliance on the reserve by FY2031. In FY2027, the County proposes using $61.2 million from the reserve to support public safety operations within the General Fund and an additional $52.6 million to support programs transitioning from ARPA funding. The County also proposes using $18.0 million from the Pension Stabilization Fund to support operations, consistent with its pension sustainability fund policy, which allows the reserves to offset higher-than-anticipated annual pension contributions.

Sales Tax Growth Supports General Fund Revenues

Sales tax remains the County’s largest individual General Fund revenue source. County officials continue to monitor broader economic conditions because approximately 61.9% of General Fund revenues are considered economically sensitive.

Pension and Debt Obligations Remain Significant

The County will use $18.0 million from the Pension Stabilization Fund to help offset a higher-than-anticipated required pension contribution. The budget also uses available debt service reserves to reduce the portion of the property tax levy directed to debt payments and make more property tax revenue available for operations.

Transportation Funding Faces Legal Uncertainty

The County expects $253.1 million in Transportation Fund revenue in FY2027 but does not authorize expenditures from those disputed revenues pending litigation over the Safe Roads Amendment. The County is appealing a ruling that found certain transportation-tax revenues were improperly used to support public safety functions and is setting aside the revenue while continuing to fund transportation and highway projects through other sources.

Capital Program Focuses on Infrastructure and Modernization

The capital program supports County facilities, transportation and highways, equipment, healthcare infrastructure, public safety needs, and technology modernization, with a focus on life-safety improvements, accessibility, and facility and technology upgrades.

Looking Ahead

The Cook County Board of Commissioners will now review the proposal through committee hearings before considering amendments and adopting a final budget, with a vote on a final budget recommendation expected by Nov. 19. Key issues to watch include federal Medicaid policy and CountyCare enrollment, rising uncompensated care, reserve utilization, transportation litigation, and the County’s longer-term pension, healthcare, and structural budget outlook.

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