After Hollande promised to generalize supplementary health to retirees by 2017, the “labeled” contract solution adopted for this purpose has been the subject of strong criticism from the mutualist world. It was therefore set aside in favor of a reform of the Evin law, which establishes a progressive cap on supplementary health rates for young retirees but removes any cap from the fourth year of retirement.
At the 2012 Mutualité Française congress, François Hollande promised a “quality mutual fund for all” at the end of his term of office. It is in this light that was entered into a national interprofessional agreement (ANI), which, since 1 st January 2016, requires all private companies to offer their employees supplementary collective health, at least half must be paid by the employer.
Despite the significant advantage that this generalization represents for employees, retirees are excluded. By taking out supplementary health insurance on an individual basis upon retirement, they must waive the part of the contribution paid by the employer.
This leads to a sharp increase in supplementary health costs - which according to the Mutualité Française go from 283 to 998 euros per year on average - often coupled with a drop in purchasing power and prices which increase with age. La Mutualité estimates that retirees pay their complementary health insurance 3.5 times more expensive than employees, which pushes 5.7% of them not to subscribe at all.
Faced with this problem, François Hollande announced in June 2015 the generalization of supplementary health to retirees for 2017. The solution adopted was to set up “labeled” contracts intended for both retirees and employees aged 65 or over wishing to benefit from them, to regulate the guarantees and prices of supplementary health insurance for this age group.
Two decrees were to introduce this system on 1 st January 2017, but strong criticism of the players of mutuality questioned its adoption. They notably denounced the categorical segmentation induced by the labeling of senior contracts, as well as the lack of interest in this system, which does not meet the specific needs of this age group in terms of care. For example, the Mutualité Française cites that the guarantees provided for orthodontics that those over 65 do not generally need, to the detriment of more relevant care for them such as implantology.
Following these criticisms, the labeling project for senior contracts seems to have been put aside by the government of François Hollande. In place of this device come into force on 1 st July 2017 reform of the Evin Law of 1989 on complementary social protection. This introduces a progressive cap on supplementary health rates over the first three years following retirement. However, no ceiling rule is provided for from the fourth year of retirement, which implies that the mutuals will then be able to set the rates of their choice.
Although it avoids excessively sudden increases in supplementary health costs upon retirement, this reform is not, however, favorable to long-term retirees. While the original text of the Evin law provided for a maximum increase of 50% in supplementary health costs for retirees without a time limit, the reform removes any ceiling from the fourth year of retirement.
It remains to be seen how the mutuals will adapt their prices to this new system: will they take the opportunity to introduce significant price increases from the fourth year of retirement, or will the game of competition push them to pull prices towards the bottom?
Besides, the government of Emmanuel Macron will also have to clarify its policy in terms of complementary health. The President of the Republic had mentioned the idea of establishing three standard contracts during his campaign, which would ensure transparency and facilitate comparisons of offers offered by insurers and mutuals.
The outline of this measure remains vague but seems to be part of the continuity of the labeled contracts of François Hollande with a generalization to all classes of the population. We will therefore have to wait for an official announcement from the government to find out more, without forgetting the reaction of the mutualist world which will undoubtedly follow quickly.
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