The National Health Insurance Committee (NHIC) is slated to discuss the 2021 National Health Insurance (NHI) premium rate on Nov. 27. The NHIC has requested the Ministry of Health and Welfare (MOWH) to provide two proposed premium rates that will replenish the NHI safety reserves back to levels equivalent to one months’ or 1.5 month’s expenditures. Sources indicate that the lowest of the proposed premium rate could be 4.97 percent. At 4.98 percent, employees residing in the NT$40,100 payroll bracket are expected to pay an additional NT$34 in NHI premium s each month, which is significantly lower than the nearly NT$100 increase required by previous proposals. It is expected that the two proposals calling for respective premium rates of 4.97 percent and 5.17 percent are mostly likely to be selected by the NHIC, with the latter representing the peak rate during the former Ma Ying-jeou Administration.
The NHIC in September discussed the 2021 NHI global budget, however, due to lingering differences on the matter, no consensus was formed, with two proposals being deferred to the MOHW for approval. Among them are the payers’ representatives’ version calling for a 3.779 percent growth rate and a NT$781.083 billion global budget, with the other being the medical service providers’ version calling for a 4.346 percent growth rate and a NT$785.353 billion global budget. To date, the MOHW has not announced its decision between the two versions. As a result, projected NHI premium rate increases have been based around the two proposed global budget amounts and growth rates.
The NHIC was originally slated to discuss next year’s NHI draft rate on Nov. 20, however, some NHIC members voiced objections, saying that the MOHW’s proposed NHI premium rates are based on replenishing the NHI safety reserves to levels equivalent to more than two moth’s expenditures, which requires NHI premium rates to be as high as 5.4 percent. Given the impacts of the pandemic, such a steep rate increase would bring undue burdens to the public. In addition, the National Health Insurance Act stipulates that the safety reserves must meet the threshold equivalent to one to three months’ expenditures, which has prompted some NHIC members to argue that smaller increases to the NHI premium rate should suffice in replenishing the NHI safety reserves to one or 1.5 months’ expenditure.
Sources indicate that the NHIA has already provided its proposed NHI premium rates to the NHIC on Nov. 25, comprised of one calling for a 4.96 percent premium rate targeting a safety reserve of one month’s expenditure. At 4.96 percent, an employee residing in the monthly payroll bracket of NT$40,100 with no dependents would be charged a monthly premium of NT$598, which is only NT$34 higher than the current 4.69 percent premium rate and brings much lower additional burdens for the public. In contrast, previous proposals have been estimated to add nearly NT$100 in monthly premiums to the public.
Another proposal calling for a 5.19 percent rate is aimed at replenishing the NHI safety reserves back to the threshold equivalent of 1.5 months’ expenditure, is expected to result in monthly premium charges of NT$624 for the same employee at the monthly payroll bracket of NT$40,100, NT$60 higher than the current rate.
However, if a premium rate that only replenishes the NHI safety reserves to one month’s or 1.5 months’ expenditure is implemented in 2021, a follow up rate increase would be required in 2022 to maintain the system’s solvency.
Sources indicate that the NHIC also asked the NHIA to provide projections of NHI safety reserves if the premium rate was adjusted to 4.91 percent, 4.95 percent and 5.17 percent of the Ma Ying-jeou Administration. The outcome of the projections suggest that at 4.91 percent or 4.95 percent, the NHI safety reserve will be less than a month’s expenditures at the end of 2021. At 5.17 percent, the safety reserve is expected to reach the equivalent of 1.46 months’ expenditures, which meets the legal requirement of at least one month’s expenditures.
In addition, at 5.17 percent, the same employee of the NT$40,100 payroll bracket will be expected to pay a monthly premium of NT$622, which is NT$58 higher than the current situation.
Persons familiar with the matter believe that there is little support among NHIC members for a premium rate that is higher than 5.4 percent and that the premium rates most likely to be implemented are 4.97 percent and 5.17 percent. However, the NHIC’s leanings could change if the government decides to pour more public budget into the NHI in accordance with the law.
[2020-11-26/Liberty Times Net]
