<p>With a projected $550 million budget shortfall next year, Cook County officials said Wednesday that the county must start considering restructuring its finances as expenses continue to outpace revenues.</p><p>It would be the largest budget deficit in Cook County Board President Toni Preckwinkle’s 15-year tenure, but the current projected shortfall is a much smaller portion of the overall budget compared to the last time it was this large.</p><p>About half of Cook County’s annual budget is a general fund and the other half a healthcare fund. The general fund’s shortfall is forecast at about $336 million, while the healthcare fund’s projected shortfall is about $215 million, according to Cook County Bureau of Finance officials who presented Wednesday the county’s financial forecast through next year.</p><p>Cook County is expected to end the current fiscal year with a net surplus of about $240 million, with the general fund projected to finish with a $283 million surplus but the healthcare fund projected for a $43 million loss.</p><p>The county’s 2027 fiscal year begins Dec. 1.</p><p>“This is going to be a really tough budget year, but we begin it from a position of strength,” Preckwinkle said, noting the county has in recent years strengthened its reserves and pension funding, and has received increased bond ratings in the last four years.</p><p>“But even strong, internal fiscal management can’t shield us from external events — court decisions, federal policy changes and rising costs across the economy,” Preckwinkle said.</p><p>Federal funding cuts to Medicaid are expected to result in about a 16% decline in average monthly membership in Cook County’s Medicaid insurance plan, CountyCare, officials said.