Question 7652 — maternity health insurance

Summary

After technical exchanges which began in November 2017, the Minister of Solidarity and Health opened a consultation phase on January 23, 2018 on the “zero-payment” reform. The Government's objective is to reduce, through this reform, the rate of forgoing care for financial reasons in three sectors: dental prostheses, hearing aids and medical optics. More precisely, it is to ensure zero out-of-pocket costs after the combined intervention of compulsory health insurance and supplementary health insurance. The “zero remaining charge” will apply to a basket of necessary and quality care, that is to say that the devices in this basket must make it possible to respond in a medically relevant way to health needs and under conditions corresponding to a legitimate social expectation, for example in terms of lens thinning for very myopic people. The freedom to choose and offer will be preserved: it must be possible for everyone to equip themselves or to use prosthetic care without any outlay, but it will be free for anyone to make another choice; it involves moving from the incurred outlay to the chosen outlay. Professionals will have the freedom to offer other services outside of this basket. Finally, all responsible contracts must offer the remainder at zero cost, but the additional insurers will be able to continue to offer, beyond this base, other support offers. Given the importance of the zero-cost remaining project for the three sectors concerned, the Government is favoring broad consultation with the stakeholders concerned: manufacturers and distributors of medical devices, health professionals, complementary health organizations and patient representatives. The consultation and negotiation framework for dental care is the conventional framework between the national health insurance fund (Cnam) and representatives of dental surgeons: negotiations began in September 2017 and are continuing. In the optics and hearing aid sector, as part of exchanges technical started last November with the ministry's services, each partner was invited to produce a contribution on the different aspects of the reform. The consultation meetings resumed at the beginning of March and will continue until the end of May 2018. The Government intends to allow the negotiation to take place freely and everyone is encouraged to express their positions and proposals. He will only make his decisions at the end of this phase and will accordingly mobilize the conventional, regulatory and legislative levers that prove necessary.

Machine translation from French. The official text remains authoritative.

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