Cook County comptroller reports $261.7 million favorable General Fund variance through March; says state owes $98 million

Cyril Thomas, Cook County comptroller, told the Finance Committee that for the four-month period ending March 31, 2026 the General Fund had a favorable net budget variance of $261,700,000, driven by a $219,400,000 favorable revenue variance and a $42,300,000 favorable expense variance. He also said the Health Fund was $27,700,000 favorable on a budget or cash basis.

"The favorable revenue variance is driven primarily by county sales tax, property tax, and cigarette tax receipts higher than forecasted," Thomas said, adding that the accrual-based financial reports prepared by the Health Fund are a better indicator of that fund27s financial condition. He told commissioners the state of Illinois owed the county $98,000,000 through March 31, 2026, including $88,700,000 due to the General Fund and $9,300,000 due to the Health Fund, with a breakdown into administrative-office, rent, and federal pass-through and state direct grants.

Commissioners pressed for follow-up on specific items. One commissioner asked about the future of DSH (disproportionate share hospital) reimbursements; Thomas said anticipated decreases have been delayed and are now expected to affect fiscal year 2027 rather than immediately. A health system representative confirmed the county's year-to-date health-system favorability was driven by revenue and expense factors, noting some offsets from increased uncompensated care.

Thomas also confirmed the county was awaiting an imminent update from the state on a health-plan RFP, and told the committee he expected word "literally any day now."

The committee received and filed the controller27s and health reports after the presentation. The comptroller concluded the report by noting a one-time federal grant cancellation of $700,000 related to BED and inviting questions from members.