How Toni Preckwinkle Is Canceling Debt, Fighting Guns, and Redefining What Government Can Do

Chicago’s top county official, Toni Preckwinkle, is showing the nation what bold, people-first governance looks like. In her recent appearance on The Good Government Show, the long-serving President of the Cook County Board of Commissioners talked about her latest wins and unwavering drive to make local government not only work—but work for the most vulnerable. From wiping out nearly $400 million in medical debt to launching guaranteed income for struggling residents, Preckwinkle’s pragmatic approach is helping restore dignity and hope in communities where the federal system sometimes falls short—or fails altogether.

Amid ICE crackdowns and political polarization, Cook County remains under pressure. But Preckwinkle refuses to govern in fear or retreat. Instead, she’s pushing forward with solutions that make tangible, measurable impacts—especially in health care. “We put $9 million aside,” she told host Dave Martin, “and that’s helped erase $382 million in medical debt for over 213,000 people.” She credits the Biden administration’s American Rescue Plan for giving counties like hers the tools to build back better, and thanks her young staffers for championing this debt-relief idea early on. “It was their idea—and they were right,” she said. The program, in partnership with Undue Medical Debt, buys back burdensome bills and cancels them outright. “Everyone wins,” she added, especially families who’d been skipping care due to crushing bills.

But Preckwinkle isn’t stopping at medical debt. She’s also behind one of the largest county-run guaranteed income programs in the country, providing 3,250 residents with $500 a month for two years. No strings attached. And it’s not just about handouts—it’s about economic resilience. Whether it’s helping a nursing student stay in school, or giving a caregiver the means to support an aging parent, the program is about letting people breathe and rebound from financial emergencies that might otherwise send them into spirals. A study from the University of Chicago will evaluate the outcomes this spring—but Preckwinkle is already committed to keeping the program alive and evolving.

She’s also investing in prevention on another front: gun violence. Rather than just increasing incarceration, she’s taken a public health approach—funding community groups, violence interrupters, and wraparound services for survivors. Her philosophy? Spend less on jails, more on prevention. “It costs $62 a day to keep someone in jail,” she said. “What if we spent that on tutoring, after-school programs, or helping people get back on their feet after incarceration?” She believes in upstream investment—and the early data show it’s working. Crime is down, and trust in government is inching up.

As Preckwinkle enters her 16th year in office, she’s running for reelection at age 78 with no plans to slow down. “If I wasn’t doing this job, I’d find another way to serve the public,” she said. Whether it’s through behavioral health programs, economic equity, or anti-violence work, her mission is unchanged: help more people. “I always say the job of an elected official is begging, wheedling, cajoling, apologizing for things you didn’t do, and working with people you can’t stand,” she laughed. That may be true—but Preckwinkle proves that if you work smart, listen well, and lead with purpose, good government is not only possible—it’s transformational.