No new taxes in 2023 county budget, but questions linger

County residents are likely to be pleased with an $8.75 billion Fiscal Year 2023 Cook County budget unveiled Thursday that neither adds new taxes nor raises existing ones.

But a look under the hood raises some interesting issues, both promising and concerning.

The more than 4,000 unfilled county jobs, primarily in health care and public safety, raises the question of whether the county can fill — or will fill — all the jobs needed to provide health care. If not, it seemingly won’t be for lack of trying, since the county is planning job fairs and hiring incentives to fill positions. But the shortage of nurses and other health care workers is a national problem, not easily solved and certainly not quickly.

It’s interesting that changes in the health care landscape have the County Board rethinking how health care is delivered. A new $230 million inpatient and outpatient Provident Hospital facility, along with putting more services in the existing facility, shows the county sees itself as part of a health care network with other providers, which is good.

But one challenge for balancing the budget is the anticipated decline of about 56,000 in the number of people enrolled in the subsidized CountyCare system, the county’s largest Medicaid plan. CountyCare will be affected by a state decision to restart annual eligibility reviews for Medicaid and also the likelihood that some people in CountyCare will switch to other managed care organizations that Illinois has set up. For each patient CountyCare loses — including those who get their services outside the county — the county will lose its administrative fee.

Guaranteed income, public safety

The budget includes a $42 million guaranteed income pilot program, a welcome initiative to help people in need with two years of supplemental monthly income. But the plan raises an important question: What will be done to lift recipients economically, by getting them into better-paying jobs that reduce the need to rely on a temporary extra $500 a month? Unless the guaranteed income program is structured to steer people to counseling, more education and other support to lift them and their families out of poverty, it risks being labeled just another “giveaway” by penny-pinching critics.

In the area of public safety, a request from Sheriff Tom Dart for a helicopter to help catch carjackers did not make it into the budget, which might not be popular with county residents worried about safety on the streets.

Other programs include $71 million for $10,000 grants to small businesses, and another $14 million to expand a program that helps provide housing for patients and hire more behavioral health specialists to help homeless patients.

The election-year budget relies on the continued use of some $1 billion in federal pandemic aid, which the county has until 2026 to spend. In the meantime, county officials will have to ask themselves hard questions about which new programs are worth paying for over the long haul — and which ones simply aren’t sustainable.

How inflation helps

Due to rising prices and the start of the online sales tax, the county is expected to bring in an additional $124 million in sales tax revenue in the fiscal year that starts Dec. 1. The increased sales tax has, in part, been key to putting the county’s pension fund in better shape than those of the city and state, with a funded ratio of slightly more than 70% in 2023.

But revenue from sales taxes — now the county’s largest source of revenue — could go down if there is a recession, and that could in turn jeopardize the county’s anticipated 7.8% increase in spending in the coming year.

At an online meeting with the Sun-Times Editorial Board on Thursday, Cook County Board President Toni Preckwinkle said there was no discussion about reducing the county’s sales tax, which adds 1.75 cents per dollar to the sales taxes paid on purchases in Cook County. She said commissioners refuse to increase the property tax rate each year to keep pace with inflation.

The County Board is expect to vote on the budget on Nov. 17. Commissioners should give it their approval.

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