Cook County Board President Toni Preckwinkle gives her 2026 budget address on Oct. 9, 2025. [Office of the President]

Cook County Board President Toni Preckwinkle on Thursday unveiled a $10.01 billion proposed budget for 2026 in an address where she also excoriated the actions of the Trump administration that are anticipated to impact the county budget.

The proposed budget is largely flat when compared to 2025’s, a miniscule 0.7 percent increase compared to the current fiscal year, or a $71.8 million increase. 

The plan closes a $211.4 million gap without layoffs, tax increases or cuts to essential services. That consisted of a $102.6 million gap in the county’s General Fund and a $108.8 million gap in the Health Enterprise Fund, which funds Cook County Health, the county’s healthcare and hospital system. 

Preckwinkle said during her address to the County Board of Commissioners the budget is reflective of the county’s “solid fiscal state” and cited four bond ratings upgrades in the last four years after making $3 billion in supplemental pension payments over the last 10 years and building up county reserves to prepare for emergencies.   

“It shows that we can do more without asking more,” Preckwinkle said. “It keeps taxpayer dollars in taxpayers’ pockets, and it means the work we've done over the last 15 years continues to pay off.”  

The number of full-time positions would rise by 83 next year, and the county’s latest vacancy total on Aug. 31 was 3,065, with about half being within Cook County Health. 

The General Fund has a proposed $2.67 billion budget next year, and county budget officials said they closed the General Fund gap by taking advantage of $168.8 million in higher-than-anticipated revenue estimates when compared to the preliminary forecast in June, including $31.3 million in additional sales tax revenue, $10.1 million in additional state subsidies for probation officers and other revenues, such as investment income and rebates, coming in $53.5 million higher than forecast this summer. 

The general fund budget was also shored up using an unassigned fund balance transfer of $383.9 million, including $179 million used as a one-time, stop-gap measure to cover public safety expenses that are no longer allowed under the Illinois Safe Roads Amendment, although the county is challenging that in court. The transfer will also support multiple one-time general fund expenditures and three of the county’s special purpose funds — the Infrastructure and Equipment Fund, Self-Insurance Fund and a fund to mitigate the loss of federal grant dollars.  

The county is at risk of losing about $64.2 million in grant money from federal cuts, according to budget officials. As a result, an unassigned fund balance transfer will establish a $65 million Federal Grant Risk Mitigation Fund to keep programs afloat if they lose their grant funding in the next year.   

It’s one way the county budget represents more of a “moral document” than ever, Preckwinkle said during her address.  

“It's a reflection of who we are and what we believe,” the president said. “It represents our collective commitment to fairness, to dignity and to opportunity. It's how Cook County delivers on its mission as a government you can trust, lean on, and especially in these uncertain and chaotic times. We remain open for business when the federal government is not, no matter what the federal government may throw our way, Cook County will be here.”

The Health Enterprise Fund has a $5.14 billion proposed budget next year and closed its gap through higher-than-forecast Medicaid net patient service revenue, private insurance patient fee revenue and payment through the Medicaid Disproportionate Share Hospital program, as well as reductions in the costs of contract labor and anticipated fringe benefit expenses and adjustments to turnover rates to account for actual hiring time. 

Preckwinkle used her speech to praise the county’s healthcare and hospital system but said federally proposed cuts to Medicaid would endanger the system’s ability to deliver the best service it can to residents. 

“We can deliver excellence at scale, but as we know that progress is under threat,” Preckwinkle said. “Federally proposed cuts to Medicaid jeopardize one of the most vital lifelines our residents have. Protecting Medicaid is not just a matter of fiscal responsibility. It's a moral responsibility to uphold the promise of health and dignity for all.” 

Additionally, Preckwinkle praised the impact of community violence intervention programs and promised to keep fighting for federal cuts to those programs to be undone as well. 

Finally, the board president promised the long-awaited completion of the transition of the county’s property tax administration system off the old county mainframe and onto a modernized online system in the forthcoming year. 

Budget hearings are set to take place the last week of October. Amendments to the budget proposal will be due Nov. 6, and the budget is set for an approval vote on Nov. 20 at the earliest.