Director Kang Cheong-hee of the National Health Insurance Service said of the 2027 health insurance premium rate freeze that "it is not good from the corporation's standpoint." The reason, Kang said, is that the rate needs to be raised slightly every year to secure a stable fiscal base. Kang also said that if freezes are repeated, it becomes harder to raise the rate by a larger margin later.
At a press briefing held in Gwanghwamun, Seoul, on the 8th, Director Kang said, "If we raise it at a steady pace every year, fees are set accordingly, so the fiscal base increases little by little," adding, "If we take a break once, we have to raise it by a big margin when we raise it again."
The Health Insurance Policy Deliberation Committee of the Ministry of Health and Welfare froze the 2027 health insurance premium rate at 7.19%, the same as this year.
Director Kang also pointed to the cumulative effect of past freezes. Referring to the freezes in 2024 and 2025, Kang said, "That impact seems likely to be large." Kang added, "Back-to-back freezes are in fact very bad," and "We have to keep carrying low premium income."
However, this does not mean the intention is to solve the fiscal problem with premium hikes alone. Director Kang said, "It is a problem to raise it excessively to the point of increasing the public burden." Kang also drew a line on the idea of raising the statutory cap of 8% for the premium rate, saying, "We are not considering that at this stage."
Instead, Kang emphasized expenditure restructuring. Kang mentioned the need to manage and adjust fees for some tests such as MRIs, and said the agency would closely scrutinize fraudulent claims and moral hazard among health care providers.
The direction of strengthening coverage was also set selectively. Rather than focusing on raising the overall coverage rate, the plan is to prioritize funding for severe diseases and rare and intractable diseases. The judgment is that if low-income people miss the timing of treatment due to medical expense burdens, larger costs may occur in the long term.
Kang also said the dependency on expanding state subsidies should be reduced. "Rather than that, we should look to reasonably increase revenue by overhauling the contribution assessment system," Kang said, adding that a reform plan is being prepared to adjust the collection system so income can be identified more accurately and premiums can be assessed accordingly.
According to the 2027 budget plan released by the ministry, next year's state subsidy for health insurance is 13.8 trillion won. That is up 1.07 trillion won from this year. The state subsidy rate will rise from 14.2% to 14.4%. But it still falls short of the statutory support standard of 20%.
The health insurance finances still have some leeway. As of the end of last year, reserves stood at 30.2 trillion won. That is equivalent to about 3 years and 5 months of benefit payments. The current balance has also remained in surplus over the past five years.
However, the fiscal trend is deteriorating. As of the end of July this year, the current balance shows a deficit of 364.4 billion won. If the outlook presented by a subcommittee of the Health Insurance Policy Deliberation Committee holds, the year-end deficit will widen to 2.8374 trillion won. Accumulated reserves are also expected to decrease to 27.3844 trillion won.
The increase in medical expenses due to aging is also a burden. Health insurance medical expenses exceeded 125 trillion won last year. Because the share of those age 65 and older in health insurance medical expenses is far higher than their share of the total population, the fiscal burden is expected to grow.
On this day, Director Kang presented "Reboot Health Insurance" as a key task for the three-year term. The idea is to link health insurance, long-term care insurance, and community-based integrated care to the life cycle, and to convert the corporation into an artificial intelligence (AI)-based health and welfare platform. The plan also calls for reprioritizing projects based on the effect relative to fiscal input and how much the public feels the impact.
Director Kang said, "Whether premiums go up or not, the corporation will fulfill its responsibility so that the public is not inconvenienced and there are no gaps in treatment."
Meanwhile, on the issue of applying health insurance to foreigners, Kang said the system would be reviewed based on all foreigners, not a specific nationality. If unjust benefit receipt cases are identified, the system will be strengthened. However, Kang was negative about applying reciprocity. "There are few countries that apply reciprocity to health insurance," Kang said, adding, "The humanitarian principle that if someone is sick, they should first be treated is different from diplomacy."
Kang also reaffirmed the intention to push for the introduction of special judicial police (Teuksagyeong) at the health insurance corporation. "Since prosecutors retain the right to request supplementary investigations and corrective action, we will proceed in cooperation with the prosecution," Kang said, adding that safeguards to prevent overreach by the special judicial police and a system to guarantee human rights would be established.
Kang drew a line under the theory that expenditure decreased due to conflict between doctors and the government. The explanation was that fiscal input from health insurance has in fact increased for emergency care and essential medical support projects.