Maternity and Health Insurance Balance Expected to Drop to €820m

The quadripartite committee met on Wednesday 7 June 2023 at Luxembourg’s Domaine Thermal in Mondorf-les-Bains to discuss matters related to health and maternity insurance.

The committee came together under the chairmanship of the Luxembourg Minister of Social Security, Claude Haagen, in close collaboration with the Deputy Prime Minister, Luxembourg Minister of Health and Social Security Minister delegate, Paulette Lenert, and the Ministry of Finance.

The quadripartite committee first examined the financial situation of the health-maternity insurance, including the financial contribution of the State for the "Covid-19" measures covered by the health-maternity insurance. Subsequently, the financial forecasts for the year 2023 were presented.

The quadripartite committee also took stock of the state of affairs with regard to improvements in the coverage of various sickness-maternity insurance benefits.

As part of the fight against the pandemic due to Covid-19 and its consequences, health insurance has had to finance certain measures, mainly extended leave for family reasons.

For measures going beyond health and maternity insurance, the Ministers of Social Security and Finance had undertaken to propose full financing of these measures by the State. This commitment was materialised by the special law of 15 December 2020 which sets the State's participation at a total amount of €386 million spread over four financial years: €200 million in 2020, then €62 million per year for 2021 to 2023.

Given that the expenditure related to these measures continued to evolve, the government undertook to follow the evolution and, if necessary, propose an adjustment of the amounts. This commitment was materialised at the end of December 2022 with the adaptation of the special financing law to add €37.5 million to the last payment instalment due in 2023.

Today, there is still a difference of around €1 million, which has its source in the extended leave for family reasons in the context of the fight against the pandemic.

“The State has covered the entire cost of the measures which go beyond the purpose of health-maternity insurance but which were necessary to support the insured during the health crisis. I would like to thank the Minister of Finance and the various departments for their constructive approach throughout this period,” stressed Claude Haagen. “The commitment is maintained and once the final accounts are available, a modification of the special financing law will be proposed” continued Minister Haagen.

The breakdown for the year 2022 showed that, despite the State’s financial participation in the measures linked to the Covid-19 health crisis (up to  €99.5 million for this year), the financial situation of health and maternity insurance generated a negative operating result of  €41.6 million.

Although the economic context, the evolution of employment and therefore the number of insured persons, is more favourable than initially forecast for 2022, the receipts, which were  €3,910.3 million, cannot fully compensate the evolution of expenditure, which will reach  €3,951.9 million in 2022.

The overall cumulative balance (global reserve) thus increases from €903.2 million euros in 2021 (24.9% of current expenditure) to €861.6 million in 2022 (21.8% of current expenditure). However, the reserve is still double the minimum limit of 10% set in the Social Security Code.

For the 2023 financial year, the latest estimates show a deficit of around €41.5 million for current operations. The overall cumulative balance should thus decrease to €820.2 million (excluding additional state participation for Covid-19 measures), i.e. 19.1% of estimated current expenditure for 2023.

The forecasts, therefore, show a tendency for a deficit in current operations in the medium and long term of the sickness-maternity insurance budget. To reverse this trend, the “financial sustainability” working group, created during the quadripartite committee of 4 May 2022, is responsible for analysing and proposing possible avenues that should ensure financial balance. A brief inventory of the work was presented with avenues for further investigation.

The “dental care” working group continued its work on improving the coverage of benefits in this area. The remaining improvements are therefore being implemented for some of them, others are being worked on and will subsequently be implemented as soon as possible.

Concerning the bill amending the amended law of 26 March 1992 on the exercise and upgrading of certain health professions, the Minister of Health announced the amendments approved by the Government Council. These have been submitted for the opinion of the Council of State and will soon be presented to the Chamber of Deputies.

Minister Lenert also announced the validation by the Government Council of the strategy for the digitisation of the national health system and the approach to implementing a single national IT system for the hospital and extra-hospital sector as it was foreseen in the coalition programme. A press conference on the subject is scheduled to take place on Friday 9 June 2023.