France shifts €1.7bn in health costs to mutual insurers and doubles patient deductibles

Government shifts costs to insurers

On Friday 24 July, Health Minister Stéphanie Rist announced that four decrees had been sent to the health insurance council for consultation. The texts modify the reimbursement split between the state-run Assurance maladie and complementary health insurers (mutuelles) for three categories: dental surgeon consultations, sanitary transport, and medicines deemed least effective. The move is part of a broader effort to curb a social security deficit now estimated at €23.2 billion for 2026, higher than previously forecast. Last month, the FIPS, which groups complementary insurers managed by social partners, had signalled that the executive intended to sharply raise the 'ticket modérateur', the portion left to the patient after state reimbursement, on medical acts via regulation this summer.

Mutual insurers warn of premium hikes

The Mutualité Française, the federation representing most mutual insurers, estimated the cost transfer at between €1.5 billion and €1.7 billion. Its president, Éric Chenut, warned that policyholders would bear the cost.

There is no magic money in the mutuelles. We will have to find ways to adjust contributions as tightly as possible.

Chenut noted that the transfer comes on top of a 6% rise in complementary health spending since the start of the year. He also questioned the clarity of the reform for patients, arguing that a medicine should either be useful and reimbursed or not, rather than subject to varying reimbursement rates of 5%, 15% or 65%.

Deductible ceiling doubled

A day earlier, on Thursday, the government announced the doubling of the annual ceiling on medical deductibles (franchises) and flat-rate contributions. The cap rises from €100 to €200 per person per year, applying to each medicine box, paramedical act, transport, and medical consultation. The minister justified the increase as necessary to fund hospital investment, access to care, and the development of the most effective medicines.

Patient groups condemn 'monumental error'

France Assos Santé, a federation of around 100 patient associations, reacted sharply. Its president, Gérard Raymond, called the deductible ceiling increase a "monumental error" that would penalise the most vulnerable.

For the sickest people, it's double, triple, quadruple punishment. They are already unwell, face high out-of-pocket costs, struggle to find doctors, and are now being pointed at because they cost money.

Raymond warned that the measures would breed distrust, lead to care avoidance, and create incomprehension among patients who pay more without seeing quality improve. He suggested examining why some patients require 50 medicine boxes or over 25 consultations a year, and reviewing prescriptions in nursing homes.

Deficit pressure drives austerity

The government's twin announcements reflect mounting fiscal pressure. The social security deficit has widened beyond earlier projections, and the executive is seeking savings before the parliamentary debate on the health budget. While the government says it will monitor that any premium increases remain "limited", insurers insist that a transfer of this scale cannot be absorbed without consequences for policyholders. The Mutualité Française stated that "these decisions will inevitably have consequences for insured persons" because any transferred health expense continues to be financed by the French, either directly or through higher complementary insurance contributions.