While Chicago residents are being warned about tax hikes, Cook County government likely won’t be piling on the pain.

There are no new fees or taxes for county residents expected in 2020, Cook County Board President Toni Preckwinkle said Wednesday as she released her proposed budget. Still, she did not rule out layoffs.

“I can’t commit to that because I never know, frankly, what the individual separately elected officials may propose,” Preckwinkle said. “We’re surely not anticipating any layoffs in the offices under the president.”

Elected officials oversee the county jail and the state’s attorney’s office, for example. Cook County is one of the largest counties in the nation, stretching from Glencoe on the North Shore to University Park more than 60 miles south.

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Preckwinkle plans to start the 2020 budget year with a small deficit of around $19 million. That’s the smallest gap since at least 2011, when it was $487 million.

“We made some very difficult decisions over the last nine years,” Preckwinkle said of how the county closed such a wide gap.

That includes laying off thousands of workers, refinancing debt and not filling vacant jobs. Preckwinkle has led the county since 2010.

County budget director Tanya Anthony attributes the 2020 deficit to expenses growing faster than money will come in. Preckwinkle initially expected the 2020 shortfall to be nearly $50 million.

This good-news budget is Preckwinkle’s first financial roadmap since she lost the Chicago mayor’s race in April to Lori Lightfoot in a crushing defeat. But it’s Lightfoot who inherited a financial mess and has said she’ll likely need to hike taxes to cover the city’s deficit and ballooning pension payments.

Cook County’s proposed budget total in 2020 likely will be similar to the current $5.9 billion budget. The county runs a two-hospital medical network and a jail, which combined make up about two-thirds of the budget.

Among highlights of the proposed budget:

• It depends in part on about $10 million in new revenue from marijuana, casinos and gaming that Illinois lawmakers recently approved. Some bills still need Gov. JB Pritzker’s approval.

• Health insurance costs for county workers are expected to climb about 6 percent, or about $12 million. This is among the biggest drivers of expenses next year.

• The county health system’s Medicaid insurance plan, CountyCare, is a big reason the health system doesn’t need as much taxpayer money as it used to. But CountyCare makes money by getting paid a fixed rate for each person it enrolls. And membership is declining. CountyCare had about 317,000 members in May, around 3 percent less than in January, state records show. Preckwinkle blamed the dwindling membership on former Gov. Bruce Rauner processing Medicaid applications too slowly.

• The county still projects years of deficits ahead, peaking at $113 million in 2024.

As for the current budget year, which ends Nov. 30, Cook County government is on track to have a slight surplus of about $15 million. That’s partly due to the county not hiring as many workers, which means not having to pay out as much in salaries and wages. Anthony, the county budget director, attributes that to a good economy.

“People have options to work in other places,” Anthony said. “Working for government just doesn’t seem as sexy, as well as the fact that some of our salaries are just not as high as in the private sector.”

Still, overtime costs are up 31 percent, or $11 million this year. Anthony acknowledged the county is looking into whether hiring workers would be cheaper.

Then there’s this: The county-run health system is facing a $103.1 million deficit by the end of the 2019 budget season. Remember that declining enrollment in the CountyCare health plan? The health system banked on having about 345,000 members a month to generate revenue. Since they had far less, the health system lost out on about $184 million. At the same time, its doctors ended up providing more medical care the county didn’t get paid for.

Ekerete Akpan, chief financial officer for the health system, outlined a plan to fill the big gap. It involves getting $60 million from the state for training doctors, not filling jobs like care coordinators that would have cost a total of $5.5 million, and shrinking contracts with vendors that work on CountyCare. That’s estimated to save about $38 million.

The moves should shrink the deficit in 2020 to around $7 million, Akpan said.

Preckwinkle’s presentation kicks off budget season. In the coming months, the county will host a series of public hearings where taxpayers can comment and question, and elected officials can compete for precious government dollars. The 17-member county board must approve the final budget, and that typically happens in November. The new budget takes effect on Dec. 1.

Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.