Proposed Cook County Budget: No Immediate Pain. But Expect Bumps Down The Road

Cook County Board President Toni Preckwinkle at City Hall on July 25, 2018.
Cook County Board President Toni Preckwinkle at City Hall on July 25, 2018. WBEZ/Bill Healy
Cook County Board President Toni Preckwinkle at City Hall on July 25, 2018.
Cook County Board President Toni Preckwinkle at City Hall on July 25, 2018. WBEZ/Bill Healy

Proposed Cook County Budget: No Immediate Pain. But Expect Bumps Down The Road

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There’s little pain for taxpayers in Cook County Board President Toni Preckwinkle’s $5.92 billion proposed budget. She unveiled that plan Wednesday.

No new fees, fines, or taxes.

“I believe this balanced budget is another step toward realizing my vision and priorities for

Cook County,” Preckwinkle said at a briefing with reporters Tuesday.

But there’s also no bold plan to close a deficit that’s projected to swell to at least $247 million by 2023.

That’ll be left to the county Board of Commissioners, which must approve the budget next month, said Ammar Rizki, Cook County chief financial officer. The new budget starts on Dec. 1. Cook County is one of the largest counties in the nation, with about 22,000 employees.

Preckwinkle’s preliminary financial roadmap for 2019 could be easier to digest than last year’s. Then, the county board battled over spending cuts and layoffs after commissioners repealed the unpopular tax on sugary beverages that Preckwinkle had pushed through.

Meanwhile, there are lots of political forces at play.

Preckwinkle is also pitching this latest budget as she runs for another job — that of Chicago mayor. Rahm Emanuel isn’t running for a third term, and Preckwinkle is among more than a dozen people jockeying for the job. That election is in February.

And county commissioners are up for election on Nov. 6, which means some commissioners likely will vote on the proposed budget as they prepare to leave the board.

Three Republicans on the majority Democratic board are notably vulnerable. As head of the Cook County Democratic Party, Preckwinkle is targeting them by throwing party funds behind three Democrats.

As for Preckwinkle’s proposed 2019 budget, it’s $712.2 million more than last year. Yet, the county still was able to close an $82 million gap officials predicted in June.

That’s partly because the county health system, a medical safety net for the poor and uninsured in the region, aims to generate a nearly $30 million surplus by boosting enrollment in its Medicaid health insurance plan. The health plan, called CountyCare, is the largest of its kind in Cook County, state records show, and it expects to have 345,000 members in 2019.

CountyCare makes money like this: The state Medicaid program pays the health plan a fixed amount of money per patient per month. So the more members it has, the more money it brings in. This also means the health system has to work hard to keep these patients healthy so they don’t cost more than the state pays to cover their medical costs.

The health system plans to expand services and hire more employees to treat its growing CountyCare membership. The system includes flagship hospital John H. Stroger Jr. on the Near West Side, Provident Hospital on the South Side, and a network of clinics.

“It’s almost like you gotta spend money to make money,” said Tanya Anthony, Cook County budget director.

Preckwinkle expects to close the rest of the projected $82 million shortfall with $52 million in additional sales tax and $8.8 million in additional non-property taxes, like a tax on gas.

Overall, the county is becoming increasingly reliant on CountyCare to bring in dollars. The health plan is expected to generate $1.8 billion in 2019, the largest chunk of revenue coming in to the county. Sales tax is expected to bring in the next highest amount, around $832 million.

The deficit is expected to reach at least $247 million in five years partly because Cook County is bringing in less revenue. For example, people are smoking less, which means the county doesn’t bring in as much revenue in cigarette taxes. And the county hasn’t increased its property tax levy in more than 20 years.

The proposed 2019 budget also includes six policies Preckwinkle wants to focus on. They include awarding about $4 million in grants to 20 community-based organizations for violence prevention and other criminal justice initiatives, and establishing the Office of Research, Operations and Innovation to rely less on outside consultants and therefore save more money for the county.

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