Mid Year Budget Meetings Begin on Day One With Significant Concerns

Note that all Mid-year Budget Meetings are held by the Finance Committee of the Cook County Board

Budget Overview from the Bureau of Finance
July 21, 2026

Chief Financial Officer Angela Manning-Hardimon, Deputy CFOs Dean Constantinou and Asley Ramchandani, and Budget Director Ishida Musselwhite provided an overview of the projected end of the year actuals vs. budget and the explanation as to why the gap between revenues and expenses for the 2027 budget year is currently at $551 M, the largest since President Preckwinkle took office in 2010.

• For 2026, the General Fund is projected to finish with a favorable $283M, in part thanks to a one-time $115 M revenue from a cigarette settlement and higher than budgeted sales tax revenues of $122.7M.  
• The Health Enterprise Fund (which covers Cook County Health that is over half of the budget) is projected to end 2026 with an unfavorable $42.8 M.
• Both Funds have projected gaps for the upcoming 2027 year of$336M for the General Fund and $214.7M for the Health Fund, for a total of $551M.

The factors contributing to the General Fund imbalance for 2027 are

• The court finding that the Illinois Safe Roads Amendment severely restricts how the County can spend money from the Motor Fuel Tax
• The growing costs of payroll and related pension costs
• The increase in employee benefit costs

The factors contributing to the Health Enterprise Fund imbalance for 2027 are

• The Federal Change in Medicaid Coverage that takes effect on Jan. 1, 2027
• The increase in the uninsured (from both the increased costs for those previously insured under the Affordable Care Act and from the projected significant reductions in those eligible for Medicaid) that results in more charity care that will be provided 
• The rising costs of payroll and contractual labor

As a result of all these factors that are expected to continue to impact the revenues and costs of the County beyond 2027, the Bureau of Finance stated that it is imperative that the County consider a restructuring of its finances by

• Increasing budget evaluation of the needs, strategic priorities, operational capacity, deferred risk and fiscal constraints.  A multi-year budgeting framework will provide a forward-looking plan that improves discipline and will support transparent decision-making.
• Restructuring of the revenue sources to diversify and increase the revenue base while considering both adequacy and equity perspectives.

However, the County remains committed:

• To continue to remain on track to fully fund the pensions by 2047
• To utilize the money set aside a couple years ago in an ARPA Sustainability Fund to be able to continue funding 12 program previously funded under ARPA, fully for 2027 and then reducing funding over the next 3 years (through 2030) unless and until new funding is found and/or the programs are accordingly reduced.

Responses to Commissioner questions:

• From Anaya:  There will be no unassigned fund balance from past years that can be used to help balance 2027’s budget.
• From Gainer:  The County has determined how to allocate the property tax revenues to help balance Cook County Health.  Currently property taxes cover the costs of Cermak, health provided to the Juvenile Temporary Detention Center, and the Department of Public Health.  Years ago, it was also used to cover uncompensated care.  CFO Manning said that the Bureau of Finance has been pressuring Cook County Health to provide a proposed balanced budget, and progress has been made.
• From Gainer:  The County receives $12 M from the cannabis tax, but the Commissioner wants to know what the total costs the County incurs in dealing with those using cannabis.  
• From Aguillar:  If the County took no steps to reduce the budget gap, by the end of 2027, it would fall below the floor for reserves under its policy.
• From Scott:  There are currently 2700 vacancies and an evaluation is going on now to determine what vacant positions need to be maintained.
• From Scott:  the expectation is that all federal ARPA dollars will be spent by the end of 2026.  Currently, there is $40 M unspent with another $40 M waiting for the invoices to come in.  (This is out of the $1 B the County got from ARPA.)

Offices under the President
July 21, 2026

Lanetta Haynes Turner, the President’s Chief of Staff, provided an overview of the some of the accomplishments of the different Bureaus and departments that are under the President.  She pointed out that while these offices are just 10% of the County’s budget and employees, they get involved with all areas of County government.  

There were a number of very specific questions from Commissioners with the following responses that may be of interest:

• From Anaya:  Asset Management expects to turn over the new Board Room to the Secretary to the Board for testing the audio-visual equipment by the end of next week, the last portion of the project.
• From Stamps: The Commissioner relayed that 5 young college graduates she sent to the County’s Job Fair at the Palmer House were not impressed.  HR Bureau Chief Haddox said that at the Fair over 60 people were interviewed and ultimately 5 people were hired from the Fair for positions under the President.  
• From Degnen:  Asked the head of Environment and Sustainability about ideas regarding water and energy use by data centers.  The response was that working with other groups and there have been many advances, such as using a closed system for water (e.g., reuse of water).
• From Degnen:  The report on the pilot Guaranteed Income Fund that has been expected all year is still being reviewed with the working group expanding to look at other such projects.  This will be provided in conjunction with the proposal for a new Guaranteed Income program.

Observer:  Priscilla Mims