Pharmaceutical News
National Health Insurance premiums, supplementary premiums to see possible adjustments

The National Health Insurance (NHI) reserve fund is close to dipping below the threshold equivalent to 1.5 months’ expenditure, adding pressure on the government to increase NHI premiums. Minister of Health and Welfare Chen Shih-chung has, on numerous occasions, said that the scale of the NHI will be increased by year-end and that discussions are being had to increase premiums. Reportedly, with a premium increase being a foregone conclusion, the health ministry has briefed the Executive Yuan on several versions of proposed premium adjustments, with increases ranging between 5 and 5.5 percent. Notably, apart from corresponding increases to both the monthly and supplementary premiums, the income bracket for individuals waived from the supplementary premium will be lowered from NT$20,000 to NT$5,000. The change is expected to affect around 3 million beneficiaries, who will be levied higher supplementary premiums.

Previously, the NHI monthly premium and supplementary premium rates were lowered in 2016 from 4.91 percent to 4.69 percent and from 2 percent to 1.91 percent, respectively. The lowered premiums led to a NT$20 billion shortfall in NHI revenues annually. Due to diminished income, the National Health Insurance Administration estimates that NHI finances had first dipped into deficit in 2017 and has been relying on its dwindling reserve fund since. As of May 2020, the NHI’s deficit has swelled to NT$24.4 billion. Subtracting the deficit from the NHI reserve fund would leave around NT$153.1 billion, which is estimated to be enough to fund 2.75 months’ NHI expenditure before the reserve falls below the level equivalent to 1.5 months, triggering a premium increase in accordance with the law.

According to five-year actuarial projections, NHI premiums should be raised from 4.69 percent to 5.69 percent, thereby enabling the system to remain solvent for the three following years. Sources close to the matter said that upcoming NHI premium adjustments will also be accompanied with the cap on copayments for drug prescriptions being raised, while diagnostic tests could resume copayment requirements. With additional income from increased copayments, increases to NHI premiums could be limited to under 5.5 percent. To preserve the long-term financial viability of the NHI, the upcoming premium increase will not be lower than 5 percent and should reside between 5 percent and 5.5 percent, with the supplementary premium being increased between 2.04 percent and 2.24 percent to. In addition, there are also plans to lower the threshold for NHI supplementary premium-exempt income from stock dividends, rent, professional practice and interest from NT$20,000 to NT$5,000, which will vastly increase the number of beneficiaries who contribute supplementary premiums.

[2020-07-19 / China Times]