Question 15161 — maternity health insurance

Summary

Mr. Emmanuel Duplessy draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the consequences of the dereimbursement of prescriptions drawn up by non-contracted doctors practicing in sector 3, provided for by article 76 of the social security financing law for 2026. As of January 1, 2027, this provision provides that medicines, examinations, medical devices and services prescribed by a non-approved doctor can no longer be covered by health insurance, regardless of the nature of the prescribed procedure or its medical usefulness. This measure introduces a difference in treatment between patients suffering from the same pathology and benefiting from an identical prescription, for the sole reason that their prescribing doctor or not is covered by an agreement with the CNAM. However, all doctors registered with the Order remain subject to the same ethical obligations, the same quality of care requirements as well as the freedom of prescription guaranteed by the social security code and the public health code. In many territories, including in areas considered to be adequately equipped, difficulties in accessing care also lead many patients to turn to non-approved practitioners due to fault. Appointments available in sector 1 or 2 within reasonable timeframes. This situation is even more marked in under-resourced areas, where many sector 3 doctors provide local care activities. The dereimbursement of prescriptions therefore risks leading to forgoing care, an aggravation of territorial and social inequalities in access to health as well as an additional shift towards emergency services already saturated. He therefore asks how the Government justifies a difference in care based solely on the conventional status of the prescribing doctor; how it intends to guarantee equal access to care and reimbursement for patients who do not have an accessible medical alternative within a timeframe compatible with their health needs; and finally, if the Government is considering a review or an adjustment of this measure in order to avoid particularly serious health and social consequences for the patients concerned.

Machine translation from French. The official text remains authoritative.

Timeline

1. 19 May 2026

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• Emmanuel Duplessy · auteur

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