Government seeks to shift healthcare costs to supplementary insurance

Paris – 29 July 2026: The French government is preparing a further shift of healthcare spending from statutory health insurance to private supplementary insurance. On 24 July, Health Minister Stephanie Rist submitted four draft decrees to the relevant bodies of the Assurance Maladie for consultation. Dental treatment, medical transport, certain medical aids and medicines with low or moderate therapeutic benefit are affected.

The mechanism is clear, but the financial burden on insured persons has not yet been conclusively quantified. If the reimbursement share of the statutory fund declines, the so-called Ticket modérateur grows: the portion that supplementary insurers cover in full or in part, depending on the contract. People without adequate supplementary coverage, by contrast, must expect higher out-of-pocket costs. Rist stressed that insurers would not necessarily have to pass on additional costs through their premiums. The planned reimbursement rates have not yet been published.

The Mutualite francaise, the umbrella association of mutual insurers, estimates the additional burden on supplementary health insurers at EUR 1.5 billion to EUR 1.7 billion. This does not yet mean that premium increases have been decided, but it increases cost pressure. Supplementary insurers calculate their premiums based, among other factors, on the scope of benefits and the age structure of their policyholder base. Pensioners and self-employed people bear premium increases directly; for employees, employers must cover at least half of the contribution for basic workplace coverage.

The government justifies the plan by citing the necessary consolidation of social security finances. The Assurance Maladie expects a deficit of EUR 13.8 billion in 2026. In its strategy paper for 2027, it points to rising pharmaceutical expenditure as well as the financial consequences of ageing and chronic illness. The draft decrees are therefore part of preparations for the 2027 social security budget, which parliament is due to debate in the autumn.

France has already implemented such a cost shift for dental treatment. Since 2023, statutory health insurance has generally reimbursed 60 percent, rather than the previous 70 percent, of the assessment basis for dental fees and treatment. The share to be borne by supplementary insurers rose accordingly. The government now intends to extend this approach to further areas of care. For medicines, the focus is primarily on products whose medical benefit has been classified as limited by the relevant assessment bodies.

In addition, the government plans to raise the annual ceiling for certain co-payments for doctor visits and medicines from EUR 100 to EUR 200. Under the usual responsible supplementary insurance contracts, such amounts generally may not be reimbursed and therefore burden patients directly.

The measures have not yet been adopted. Following consultation by the Assurance Maladie bodies, the government may issue the decrees. Reimbursement rates, the date of entry into force and possible protective provisions will become binding only with the final texts.