Mutual insurance prices will jump by 8.1% in 2024, a record increase

This is another hard blow for the French budget. The price of mutual insurance companies will jump by 8.1% in 2024, a level never reached. Aurélien Rousseau, the Minister of Health, may have summoned stakeholders in the sector on Friday to call on them to show moderation, but this warning shot changed nothing. Prices will increase by 7.3% for individual contracts (used by retirees, self-employed people, etc.), 9.9% for compulsory collective contracts (applied to employees) and 7.7% for optional collective contracts, reveals this Tuesday morning the Mutualité Française, based on a representative survey covering 38 mutual insurance companies and 18.7 million people covered.

While calls for contributions have already been sent to policyholders, the minister acknowledges that he cannot change much: he admitted on Friday on franceinfo that he had “fairly little direct power over the increase in the prices of complementary mutual insurance” and invited the French to “compare and, if necessary, change complementary health insurance”. But employees can neither compare nor change mutual insurance since the generalization of complementary health insurance in companies established in 2016 by Marisol Touraine, Minister of Health under François Hollande. “Mutual insurance is compulsory per company, so employees are tied hand and foot. Especially in SMEs and VSEs where the contracts are less attractive than in the big companies,” regrets one policyholder.

Also readMutuelles: is the 8% to 10% increase in prices in 2024 really justified?

Faced with this outcry, mutual societies are defending themselves. “The minister agreed that he could understand increases of up to 7%, but ultimately the median is not that far from that,” argues Éric Chenut, president of Mutualité Française. For half of the individual contracts the increase will be less than 6.5%, and for half of all contracts the increase will be less than 6.9%. For individual contracts, the 5% that increase the least will record an increase of 2.5%; the 10% that increase the most will show an increase of 10%. On compulsory collective contracts, the best-off 5% will not increase, while those who climb the most will suffer a jump of 11.7%, details the Mutuality.

If these figures on the median increase in contracts are intended to be more reassuring, they cannot hide the fact that the average increase in the bill looks set to be much higher than in past years. An outbreak driven by the dynamics of health spending, which increased by 6% in 2023, far from the 3% to 4% forecast. “This reflects the health needs of an aging population. Added to this are the revaluations of paramedical professions, recorded during the 2023 negotiations, which must be passed on” explains Éric Chenut, recalling that mutual societies are obliged, by prudential rules, to be in balance and not can make a deficit like Health Insurance.

Mutuals also cite the impact of reforms decided by the government. This is particularly the case of the emblematic reform of “100% health”, Emmanuel Macron’s campaign promise aimed at reducing the remainder of the charge for glasses, dental crowns and hearing aids. “We thought that we were at the plateau of the 100% health effect in 2022, but in 2023 many policyholders had treatment, particularly dental. We are not yet at the end of this reform,” points out Éric Chenut. Added to this is also the government’s decision to increase the co-payment from 30% to 40% on dental care, which has repercussions on complementary services.

A list of additional charges which, however, hides fewer expenses, taken into account by Social Security… “Health Insurance takes care of 300,000 to 400,000 additional long-term illness (ALD) patients each year”, observes Thomas Fatôme, its general director. Patients covered 100% by Social Security, who are therefore deducted from the costs of complementary services. In addition, “the average reimbursement rate for medicines is increasing significantly in our country because innovative medicines are gaining more weight,” he adds. Finally, Health Insurance retorts that the dental transfer spread over two years (2023 and 2024) only represents 1.6% of the expenses covered by complementary organizations and that mutual insurance companies have signed agreements to increase the prices of paramedical professionals.

Regularly criticized for the weight of their management costs, which represent nearly 20% of the sums collected, mutual insurance companies point out that they have costs of winning over and retaining policyholders that cannot be reduced, and that their management costs have already fallen by 2 % between 2019 and 2021. And the scenario of a “greater Social Security” – aiming to merge health insurance and supplementary insurance – a time envisaged to put an end to this double reimbursement system was quickly closed, the mutuals reminding in passing that the French people benefit from the lowest out-of-pocket health costs in Europe.

In this tense context, some companies are considering reviewing the healthcare basket, even if there are currently no renegotiations in this direction. “We would like there to be more latitude,” argues Éric Chenut, “so that we can review the framework of the responsible and joint contract which entails a very high level of cost.” But one thing is certain, while health spending is increasing faster than GDP, France will face a real sustainability problem if it does not find levers for efficiency gains to avoid redundant or inadequate care. The Health Insurance deficit will reach 11 billion next year and 17 billion in 2027. A worrying trajectory, facing which all stakeholders in the health system are calling for the establishment of a multi-year trajectory, giving visibility and readability.