0
Panoramic view of National Health Insurance Service headquarters. / National Health Insurance Service

As the National Health Insurance is expected to shift into a deficit this year, government state subsidies are falling short of the standards stipulated by law. Over the past 10 years, unpaid government financial support has surpassed 19 trillion won, prompting voices pointing out the need to clarify the statutory basis for such support. In response, the government plans to explore ways to resolve financial issues, including expanding state support using surplus tax revenues.

According to relevant ministries and agencies on the 26th, the government state subsidy rate allocated for health insurance this year stands at 14.2%, down 0.2 percentage points (p) from last year. Under the current National Health Insurance Act and National Health Promotion Act, the government is stipulated to provide an amount equivalent to 20% of the projected health insurance premium revenue for the corresponding year. For the subsidy, an amount equivalent to 14% is covered by general account state subsidies funded by tax revenues, and 6% is covered by the Health Promotion Fund created from tobacco taxes.

Although the subsidy system was introduced in 2007, there has not been a single instance where the government met the statutory support ratio. As a result, over the past 10 years from 2016 to last year, government subsidies fell short by a total of 19.4531 trillion won compared to the amounts mandated by statutory standards.

The issue is that not only is state support falling short, but health insurance finances are also steadily deteriorating. According to the Ministry of Health and Welfare's "Second Comprehensive National Health Insurance Plan (2024–2028)," the current account balance of health insurance finances is projected to turn into a deficit starting this year.

Amid worsening health insurance finances and inadequate government support, various sectors are raising voices demanding stable funding. Some civic groups, including the Movement Headquarters for Free Medical Care, issued a statement on the 27th of last month demanding that the 20% health insurance state subsidy rate be immediately reflected in next year's budget, stating, "While health insurance finances have been utilized for government policies, the statutory duty of state support has not been fulfilled." The National Assembly Budget Office also pointed out in a report last June, "There is a need to resolve structural instability in government subsidies, including the lack of permanent statutory grounds for support."

In light of such criticisms, the government has acknowledged the issue and is exploring solutions. During a roundtable meeting on regional, essential, and public healthcare held on the 22nd of last month, President Lee Jae-myung responded to concerns about insufficient state subsidies for health insurance by saying, "The government is also giving careful thought to that issue."

In that process, measures to utilize surplus tax revenues for health insurance state support are being reviewed. Minister of Health and Welfare Jung Eun-kyeong stated at a National Assembly Health and Welfare Committee meeting on the 19th, "We will consult on ways to further expand state support for health insurance using surplus tax revenues."

The National Assembly is also preparing legislation to expand state support. Lawmaker Han Ji-a of the People Power Party introduced amendments to the National Health Insurance Act and National Health Promotion Act on the 19th to explicitly define the state subsidy ratio for health insurance finances and the Health Promotion Fund—previously stipulated as "equivalent to"—as "at least 14%" and "at least 6%" of projected premium revenue for the corresponding year, respectively.

                                                                                                          Seo Byung-joo