Health insurance funds should let go of their reserves

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The National Council opens a breach in the obligation to restore the excessive reserves in the basic health insurance. But it will still need the approval of the Council of States.

The National Council followed Philippe Nantermod’s proposal to institute a mechanism for restoring reserves when the coverage rate exceeds 150%.

DR

The National Council on Thursday accepted a parliamentary initiative by Philippe Nantermod (PLR / VS), which proposes a mechanism for capping the reserves of the funds for basic health insurance. On the other hand, he refused a series of initiatives from the cantons of Ticino, Geneva, Vaud, Jura, Friborg and Neuchâtel, which also demanded that insurers be required to maintain their reserves at 150% and to return the amounts that exceed them.

“At more than 150%, we give the money back!”

In a short debate, Pierre-Yves Maillard (PS / VD) recalled that the reserves of the funds had soared in recent years to reach more than 12 billion francs. Some of them reach coverage rates that exceed 200%. “12 billion is twice the level of legal reserves, he denounced, 6 billion is enough for very good coverage. Assuming that two or three billion are still needed, there would still be three or four at the end of the year, which corresponds to a 10% increase in premiums. We must have the political courage and give a signal by adopting these initiatives. At more than 150% we return the money!”

The Council of States not hot

As a reminder, last year the Federal Council has decided to act so that the funds reduce their reserves, but always according to their good will. Since then, some have reimbursed small amounts to their policyholders, others have used this flexibility to reduce 2022 premiums. But the problem is not solved for the aforementioned cantons, which require a binding version of the reduction of reserves. The Council of States rejected their proposals last year by 20 votes to 17. The ad hoc committee of States also refused Philippe Nantermod’s initiative, narrowly, by 6 votes to 5.

An annual restitution mechanism

The restitution mechanism proposed by the Valaisan is quite simple: “When an insurer’s reserves exceed 150% of the minimum level, the excess is redistributed to policyholders the following year, in the form of a deposit on premiums to pay. The amount is distributed by canton and by category of insured in proportion to the amount of premiums paid.

“A superfluous woolen stocking”

By 107 against 58, it is therefore this solution which was adopted on Thursday. For Philippe Nantermod, the money from the excess reserves “is not used for the insured. It was not used during the pandemic. This is a superfluous woolen stocking. This money belongs to the citizens, and at a time when we are again talking about massive increases in premiums, a little boost in the form of a redistribution of these excess reserves seems welcome”.

His proposal must now pass the course of the plenum to the Council of States, which is another pair of sleeves.

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