The reduction in the reimbursement rate by Social Security from 70% to 60% of doctor’s consultations is an “option” considered, but the terms could be readjusted, the Minister of the Budget indicated on Friday, deeming this measure “necessary”.
To save on Social Security spending, the Social Security financing bill (PLFSS) for 2025, presented Thursday, provides for a transfer of costs from Health Insurance to complementary health insurance set at “one billion euros”.
To achieve this, the government plans to lower the reimbursement rate for consultations with doctors and midwives by Health Insurance from 70% to 60%, to proportionally increase the share of complementary health insurance (or of the patient if they do not does not benefit from an additional fee), called a “moderator ticket”.
This figure “is part of the options”, confirmed the Minister of the Budget, Laurent Saint-Martin, on RTL.
“What is expected is a transfer of one billion euros.” “It may correspond to a change in the co-payment from 30% to 40%”, but “the parliamentary debate will perhaps lead us to other balances”, indicated Thursday, during the presentation of the budget, the Minister of Health Geneviève Darrieussecq.
This provision falls under the regulatory power (decrees, orders, etc.), the bill does not precisely establish the “operational modalities” of the measure, its date of entry into force, nor even the types of consultations concerned (doctors, midwives, dentists, etc.).
In addition to parliamentarians, discussions will take place with “representatives of the sector” (insurers, mutual societies, doctors), according to the government.
Asked whether he “wished” for this change from 70 to 60%, Laurent Saint-Martin replied “yes”, describing the measure as “necessary”.
The government’s objective is “to avoid an even greater slippage in Social Security accounts. We need mutual societies to be able to take a larger share,” he said.
“The remaining dependents in our country are one of the lowest of all OECD countries,” Ms. Darrieussecq further justified on Thursday, specifying that the measure will not concern “people with long-term illnesses”, or the most precarious, protected by “complementary health solidarity” (C2S).
But 4% of French people – or 2.5 million people according to Irdes – do not benefit from complementary health insurance and will see their out-of-pocket costs increase.
In addition, the measure effectively amounts to making households pay, since this transfer of charges estimated at approximately one billion euros by the government will ultimately not fail to be reflected in the prices of complementary health insurance, which have already experienced an increase of around 8% on average in 2024.
Discussions will take place “with additional insurers so that this is done as minimally as possible”, promised Geneviève Darrieussecq.
