Cantons have a duty after the SP’s no to the premium initiative
Published: Sunday, Jun 9th 2024, 18:40
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Expenditure on health insurance premiums will not be limited to a maximum of ten percent of disposable income for households. Following the surprisingly clear no to the SP's premium relief initiative, the cantons now have a duty.
On Sunday, 55.5% of voters rejected the popular initiative "Maximum 10% of income for health insurance premiums (premium relief initiative)". The turnout was 45.4 percent.
A look at the voting map showed a deep linguistic divide. All French-speaking cantons and Ticino supported the referendum. With the exception of the canton of Basel-Stadt, however, all the German-speaking cantons said no.
"No protest vote"
A cap on health insurance contributions was not capable of winning a majority, although high insurance costs are regularly perceived by the Swiss population as the number one issue of concern. During the referendum campaign for the initiative, approval ratings dwindled in opinion polls.
Political scientist Lukas Golder from the gfs.bern research institute explained that the debate in German-speaking Switzerland had recently been dominated by financial policy. After the yes vote on the 13th AHV pension in March, the population realized that the referendum would have had major cost implications.
According to Golder, the expected average turnout did not play into the initiative's hands either. "There was no protest vote."
Subsidies that cannot be financed
The initiative demanded that all households should pay a maximum of ten percent of their disposable income on premiums and that they should receive a premium reduction for the amount above this. According to the text of the initiative, the federal government should cover two thirds of total expenditure. The cantons should finance one third.
The Federal Council, parliament, cantons and well-known business associations rejected the SP initiative. They pointed out that there are already programs to support the needy. The core argument of the opponents was that expanding premium reductions in line with the initiative would have cost taxpayers CHF 3.5 to 5 billion a year and could only have been financed through tax increases.
Moreover, the initiative would only have tackled the problem of rising healthcare costs symptomatically, but not at its root, argued conservative forces. The major challenges could be solved with more market and personal responsibility instead of additional subsidies.
Cantons must do more
During the referendum campaign, opponents referred to the indirect counter-proposal adopted by Parliament, which will come into force after the No vote. In future, the cantons will have to pay a minimum contribution of 3.5% to 7.5% of the costs of compulsory basic insurance for the premium reduction.
"All cantons must join in," said Health Minister Elisabeth Baume-Schneider. Baume-Schneider wants to submit the draft ordinance for the implementation of the counter-proposal for consultation this year and adopt it next year. From 2026, the cantons will be obliged to do more.
In future, cantons with high healthcare costs will have to pay more in premium reductions than cantons with low costs. The federal share will remain unchanged.
Old demand is relaunched
Unlike in the vote for a 13th AHV pension, the left was unable to offset the cost implications of the initiative with stronger arguments. As a consequence of the defeat, the SP announced an initiative for a public health insurance fund. This is to be launched at the beginning of 2025.
For the Greens, there is only one option left after the No vote: income- and wealth-based premiums. The unsocial per capita premiums must disappear. Parliament must finally ensure a fair distribution of the premium burden. For the trade union Unia, it was clear that wages must now rise.
In fact, the pressure for further relief measures is unlikely to diminish even after the No to the premium relief initiative. The comparison portal Comparis predicts that basic insurance premiums will continue to rise by an average of six percent in 2025.
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