Toni Preckwinkle is running for a fifth term as the Cook County Board of Commissioners President in the upcoming general election on November 3, 2026.
Preckwinkle comfortably won the Democratic primary on March 17, 2026, securing roughly 68% of the vote to defeat her progressive-moderate challenger, Chicago Alderman Brendan Reilly.
In the November 3 Illinois General Election, Preckwinkle will face Libertarian challenger Michael Murphy. No Republican candidate is running for the position, making her heavily favored to win. If reelected, Preckwinkle will tie George Dunne’s historic record for the longest-serving Cook County Board President by serving a fifth term. She has announced that this will be her final four years in office.
First elected in 2010, Preckwinkle campaigns on her 15-year tenure managing a more than $10 billion county budget, overseeing local health programs, the court system, and the sheriff’s office.
Though her primary campaign faced scrutiny over rising property taxes and data-sharing transparency, her platform remains strongly anchored in progressive policies, expanding affordable housing, and providing anti-Trump leadership at the local county level.
N’DIGO sat down with Toni to discuss the upcoming election and is sharing their conversation with you.
Donald Trump hates Obama and is doing everything to destroy the Affordable Care Act. Through the “Big Beautiful Bill” passed in 2025, Federal HR 1 Bill Trump has imposed serious cuts to health care.
In Illinois, steps have been taken that make it harder to qualify for Medicaid. Adults who are asylum seekers and victims of trafficking are no longer eligible for Medicaid. This affects people ages 19 to 64.
In January 2027, you will have to renew coverage every six months. You must prove 80 hours of work, volunteering, school, or job training and show $580 in monthly income from the previous month. There is an exception for complex medical cases. You will have to be certified twice a year, not once. This will affect 400,000 people in Illinois; 200,000 people in Cook County will lose coverage.
N’DIGO: So what do we do?
Toni Preckwinkle: WE need to let people know these changes are coming. People must keep their phone number and mailing address updated with the State Medicaid Office. Illinois of Health Care and Family Services. They send the notices out. If you are not reachable, they will dismiss you automatically. You can also go to GetMedicaidFacts.com. For more information.
Does this mean overload for Cook County Hospital?
We will be impacted; charity care numbers increase. We have increased from 13% to 25.6%. That’s 100 million more than anticipated, with less revenue. $138 million less in income.
What kind of cases are affected?
Everything. When people lose coverage, they tend not to go to the doctor. If you Don’t have preventive care, you become more seriously ill.
How do we accommodate this?
We have to raise taxes. I am not prepared to have health care cut to the bone. Half of the budget is health care.
Medics talk about HERD Health; what is this?
This means pay attention to the people around you. Access to care for all who need it. Vaccines and providing care to people who have illnesses, because vaccines protect.
Are you absolutely sure that you will raise taxes?
Yes. I am not sure what taxes. We are making cuts. There will be 10% cuts this year. We are eliminating vacant positions. We need money to provide services.
Who does this affect most?
Mostly Black and brown people and working people who don’t have insurance on their jobs. For Medicaid, 19 to 64 years old is the demographic; Affordable Care Act.
How should the public react?
The rules are changing; keep the state informed of notices. Most importantly, we have to elect people who believe in health care for ALL in this country. This is a deliberate effort to destroy Obama’s medical plan, to save money, and to provide it to rich people.
The entire country will be affected. The change of rules is federal, a national change. The Big Beautiful Bill of 2025 is damaging.
One of the things the County did was to provide Medical Debt Relief. Medical bills and long-term illness are the most common ways to become bankrupt. I used some of the rescue money for Debt Relief for 800,000 people in Cook County.
