Councils want to include insured persons abroad in risk equalization
Published: Tuesday, Feb 27th 2024, 09:40
العودة إلى البث المباشر
In future, foreigners insured in Switzerland - for example cross-border commuters - should also be included in the risk equalization between health insurance companies. Parliament is of this opinion. This will increase premiums for foreigners.
After the National Council, the Council of States also backed the Federal Council's proposal in principle on Tuesday. The small chamber approved a revision of the Federal Health Insurance Act (KVG) by 40 votes to 0 with one abstention.
With this bill, the Federal Council wants to strengthen solidarity in compulsory health insurance. This is because risk equalization within the health insurance funds was created so that health insurers do not have an incentive to only insure people who are as healthy as possible.
Insurers that have few people with a high risk of illness pay contributions to the risk equalization fund. Insurers that insure many high risks receive contributions from this.
Cross-border cantons benefit
If insured persons living abroad are included in the risk equalization scheme, their premiums will rise - but they will still be significantly lower than the premiums in Switzerland. At the same time, insured persons in Switzerland, especially those in cantons with cross-border commuters, will benefit from lower premiums.
Around a third of Swiss health insurers offer health insurance for people living in an EU/EFTA member state or in the UK. Some of them only offer insurance in individual EU states.
The premiums must cover the costs incurred by the insured persons of all these states. Insurers must calculate a separate premium for each state, taking into account the differences in costs between the states.
According to the Federal Council, the number of people resident abroad with health insurance in Switzerland is rising steadily. In 2021, around 170,000 foreigners had health insurance in Switzerland. These are mainly cross-border commuters from Germany and France.
New rules for phantom policyholders
The revised law also provides for a simplified exchange of data between insurers and the cantons so that they can fulfill their respective tasks more easily. This implements parliamentary initiatives.
The Council of States agreed with the National Council's decision to allow the exchange of data, which makes it possible to suspend the insurance obligation for so-called phantom policyholders - i.e. people who have been unable to contact insurers for some time.
According to Commission spokesperson Pirmin Bischof (center/SO), this concerns around 6000 people. These people should be able to be insured retroactively as soon as they reappear. However, the small chamber decided to clarify the National Council's decision by anchoring the suspension of the insurance obligation for phantom insured persons in a new paragraph in the KVG.
Dispute over statistics
The National Council also decided that the nationality of insured persons should be recorded for statistical purposes when granting benefits under compulsory health insurance and for premium reductions. The Council of States rejected this by 20 votes to 19 with 2 abstentions.
From the point of view of those in favor of such a provision, the collection of this data can lead to greater transparency in the use of healthcare services. Opponents, on the other hand, speak of unnecessary bureaucracy.
The bill goes back to the National Council to iron out the differences.
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