Comptroller reports $203.5 million favorable General Fund variance; Cook County Health posts mixed results

Cyril Thomas, Cook County comptroller, reported to the Finance Committee that for the one-month period ending Dec. 31, 2025 the General Fund showed a favorable net budget variance of $203.5 million, composed of a $186.5 million favorable revenue variance and a $17.0 million favorable expense variance.

"The General Fund had a favorable net budget variance of $203,500,000," Thomas said, and he attributed the revenue upside primarily to sales tax receipts coming in higher than forecast. He also said the health fund showed a $3.8 million favorable net budget variance on a cash basis but cautioned that accrual-based reports are a better indicator of the health fund's financial condition as an enterprise fund.

Thomas told the committee that as of Dec. 31, 2025 the State of Illinois owed Cook County about $99.8 million, including roughly $92.4 million due to the General Fund and $7.4 million due to the Health Fund; he said the receivable included federal pass-through and state direct grants and other items.

Scott Spencer, interim chief financial officer for Cook County Health, told commissioners the health system was $3.8 million favorable to budget on a year-to-date basis. "Revenues [were] $54.6 million ahead of plan, mostly due to the timing of property taxes and patient fees," Spencer said, but he added that expenses were $50.8 million unfavorable because of accelerated payments of claims made at the beginning of the year. He said there were no past-due capitation payments from the state.

A commissioner asked whether an employee named Pam had departed the health system; Spencer said she retired on Dec. 26. After brief questions the committee moved to receive and file the comptroller's and Cook County Health's reports.

The committee concluded by adjourning; no further fiscal actions to alter these reports were taken at the meeting.