Question 15535 — maternity health insurance

Summary

Mr. Pascal Jenft alerts the Minister of Health, Families, Autonomy and People with Disabilities to the consequences of article 76 of the finance bill for 2026. The latter provides that from January 1, 2027, health products, procedures and services established by doctors practicing in sector 3 will be dereimbursed by the National Health Insurance Fund (CNAM). pathology and receiving the same prescription, will not benefit from the same reimbursement if one consults a doctor approved in sector 1 or 2 and the other in sector 3. This would constitute a break in equality, even though it is included in our constitutionality block; especially since all doctors are subject to the same ethical obligations, regardless of whether they are approved or not, according to articles L. 162-2 of the code of social security and articles R. 4127-8 and R. 4127-53 of the public health code. This measure will penalize all patients throughout the national territory. Indeed, in normally well-equipped areas, the majority of doctors in sector 1 and 2 no longer accept new patients and doctors in sector 3 then fulfill a function of providing access to routine care. Therefore, depriving these patients of reimbursement amounts to sanction the use of the only available practitioner. This reality will be more acute in areas recognized as under-dense, according to data from the Ameli file and the work of the sector 3 doctors' union, 56.7% of the 1,126 non-contracted doctors practice in these areas. In total, more than a million French people will be deprived of reimbursement for their prescriptions, forgoing care and deferring to services. emergency services - already saturated - would not be sustainable, both in health and budgetary terms. This is why he asks how the Government intends to guarantee equal care for all insured persons and continuity of access to care throughout the national territory from January 1, 2027, the date on which the measure will come into force.

Machine translation from French. The official text remains authoritative.

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