Social Security Budget: the key points of the text definitively adopted by Parliament

Here are the main points of the text which was approved by the upper house by 225 votes to 104, in the same terms as in the National Assembly, where Prime Minister François Bayrou resisted several motions of censure.

Health care spending on the rise

The Social Security Financing Bill (PLFSS) increases health insurance spending - the national health insurance spending target (Ondam) - by 3,4% in 2025, to bring it to 265,9 billion euros.

This is more than the increase predicted by former Prime Minister Michel Barnier (+2,8%), particularly because the Bayrou government has increased the hospital budget by one billion euros.

The Bayrou government also increased the emergency fund for nursing homes to 300 million euros, compared to the 100 million euros initially planned.

To achieve this target of +3,4%, Health Insurance will have to find 4,3 billion euros in savings.

Increase in employer contributions

The former Barnier government wanted to reduce overall exemptions from employer contributions enjoyed by companies by 4 billion euros, to make them participate in the effort to redress their accounts.

The Bayrou government finally decided that this reduction would only be 1,6 billion euros.

Contribution of mutual insurance companies

The Bayrou government has promised to "recover" one billion euros from health insurance companies in a future text.

The executive believes that they have already anticipated in their 2025 tariffs measures which ultimately did not take place, which the supplementary insurance companies deny.

Behavioral taxes

To allow the Social Security to collect new revenue, the text increases the "soda tax" (intended to limit the quantity of sugar) and the taxation of online games and lotteries.

The increases on online gaming and lotteries will come into effect on July 1, and the increases on sugar on January 1, 2026. The expected gain is more than 300 million euros.

On the other hand, the government has given up on accelerating the increase in tobacco taxes that the Senate had proposed.

Capping of daily allowances

The government plans to lower the ceiling on daily allowances paid by health insurance in the event of work stoppage. The allowance (50% of the daily wage) would be capped at 1,4 times the minimum wage, and not 1,8 times as it is today, for an estimated gain of 400 million euros.

Control of radiology expenses and approved taxis

A much-debated article aims to force representatives of radiologists and taxis approved for medical transport to conclude "expenditure control" agreements with Health Insurance. These agreements must set a financial trajectory and territorial distribution objectives.

In the absence of an agreement allowing for savings of 300 million euros "over the years 2025 to 2027", health insurance will be able to impose price reductions.

Another article modifies the rules for taxi agreements. If the measure is adopted, health insurance could eventually refuse certain requests for new agreements, in areas where the density of taxis transporting patients is sufficient.

Relevance of prescriptions

To prescribe certain acts, particularly expensive health products, or medical transport vouchers, the list of which will be defined by decree after "consultation" with professionals and patient associations, the prescribing doctor will have to fill out a form allowing Health Insurance to verify its relevance. Otherwise, he will not be reimbursed.

Fraud

An article aims to facilitate the exchange of information between health insurance and supplementary health insurance, with the aim of combating fraud more effectively.

But according to the complementary health insurance companies, the wording ultimately chosen by the government reduces the effectiveness of the system to nothing, by maintaining the impossibility of direct exchanges of information on fraudsters between health insurance and complementary insurers.

"We are each doing the same work on our own, without being able to coordinate or discuss the errors identified. It's absurd," regretted Thomas Saunier, president of the Malakoff Humanis health insurance company, on Thursday.

Vital card

The text concretizes, by law, the announced deployment of the dematerialized vital card, coupled with authentication with the dematerialized national identity card (CNI), via a dedicated application. This "card on smartphone" will be optional.

Rabbit tax

The text opens the way to penalties for patients who do not honor their appointments with a caregiver. The concrete modalities are referred to a future decree.

Deficit at 22,1 billion

The initial PLFSS predicted a deficit of 16 billion euros.

But with the delay since the censure, the abandonment of certain measures (lower revaluation of pensions, reduction in the reimbursement rate for medicines and consultations, etc.) and the deterioration of macroeconomic forecasts, the government now predicts a Social Security deficit of 22,1 billion euros at the end of 2025.