Question 16127 — maternity health insurance

Summary

Mr. Roger Chudeau questions the Minister of Health, Families, Autonomy and People with Disabilities on the consequences of article 76 of the social security financing law for 2026, which provides that from January 1, 2027, health products, procedures and services prescribed by doctors practicing outside of an agreement with health insurance will no longer be reimbursed. This provision risks directly penalizing hundreds of thousands of patients who, for lack of an available alternative, now consult a non-approved doctor in order to obtain an appointment within a timeframe compatible with their health needs. In many territories, including areas that are not officially classified as under-resourced, contracted doctors no longer accept new patients or offer waiting times of several weeks, or even several months. For many French people, using a non-approved doctor constitutes the only truly accessible solution to quickly benefit from a medical consultation. However, the measure provided for in Article 76 would result in a social insured person being deprived of reimbursement for medications, biological examinations or radiology procedures that are medically justified, not because of their state of health or the nature of the care prescribed, but only because of the administrative status of the practitioner consulted. This situation raises legitimate questions about equal treatment between socially insured people. Two patients suffering from the same pathology and benefiting from the same prescription could be subject to different reimbursement rules depending on the mode of practice of the doctor consulted. The consequences could be particularly burdensome in territories already faced with an insufficient medical supply. The poorest patients would be the first affected. Many could be led to postpone or forgo certain treatments, examinations or follow-up consultations, at the risk of worsening their state of health. This situation could also lead to additional referral to hospital emergency services, already highly demanded. While access to care constitutes one of the main concerns of fellow citizens and the fight against medical deserts is regularly presented as a national priority, this measure appears likely to accentuate territorial and social inequalities in health matters. Consequently, he asks what measures the Government intends to take to guarantee equal care for all socially insured persons, to prevent the renunciation of care and to ensure that all French people have effective access to medically prescribed treatments and examinations, whatever the situation of care provision in their territory.

Machine translation from French. The official text remains authoritative.

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