With a national health insurance deficit of €23.2 billion this year instead of €19.4 billion, the government will ultimately cut back on medical appointments and medication reimbursements.
An Unprecedented Increase
The government, speaking through Health Minister Stéphanie Rist, confirmed the preparation of a decree aimed at doubling the annual ceiling on medical deductibles and flat-rate copayments. Currently limited to €50 per category (one for medication packages, paramedical services and transportation; the other for consultations, X-rays and analyses), the maximum cumulative ceiling that Social Security can retain will thus rise from €100 to €200 per year per person.
This unprecedented increase fits into a broader effort to restore public finances in the face of a health insurance shortfall exceeding €20 billion. concretely, for patients, this reform will depend directly on their care consumption. If a decree formalizing the higher unit amounts is eventually published, individual withholdings could rise. Conversely, for people who rarely see a doctor and consume few medicines, this doubling of the ceiling will not change their actual expenses since they will never reach the annual limit.
18 Million French People Exempt
On the other hand, the impact will be immediate and significant for patients suffering from chronic conditions or living with a long-term illness (ALD). These individuals consume large amounts of medication and schedule numerous medical appointments, which quickly exhaust their ceilings. They will thus see their annual out-of-pocket remainder increase by an additional €100. Moreover, mutuals and insurance contracts do not legally have the right to reimburse these specific deductibles, leaving the sum entirely to the households.
Nevertheless, the government notes that nearly 18 million French people remain fully exempt from these deductibles. This exemption covers notably minors, beneficiaries of the Complementary Health Coverage (CSS), of State Medical Aid (AME), as well as pregnant women starting from the sixth month of pregnancy. Nonetheless, the contemplated measure already faces strong criticism from consumer associations, who argue that it adds pressure on patients’ purchasing power.
