Next year's National Health Insurance premium rate will be kept at 7.19%, the same as this year.
Even as this year's National Health Insurance finances are expected to swing to a deficit, the government judged it can operate the finances without an additional premium hike, citing expenditure efficiency and increased premium revenue.
Vice Minister Lee Hyeong-hoon of the Ministry of Health and Welfare on the 8th explained the background for freezing the premium rate at a briefing after the 15th plenary meeting of the Health Insurance Policy Deliberation Committee, saying, "The current account balance of the National Health Insurance has remained in surplus over the past five years, and reserves are sufficient."
According to the ministry, it expects an annual fiscal savings effect of about 2.95 trillion won through a drug price system overhaul and adjustments to specimen and imaging fees, and projected that premium revenue will also increase by about 3.8 trillion won thanks to the boom in the semiconductor industry.
However, as of the end of July this year, the National Health Insurance current account posted a deficit of 364.4 billion won, and a deficit of 2.8374 trillion won is expected at year's end. The government's position is that, considering accumulated reserves, expanded state support next year, and the outlook for increased premium revenue, there is no problem in fiscal management. The following is a Q&A from the briefing by Vice Minister Lee Hyeong-hoon of the Ministry of Health and Welfare.
-What is the reason for freezing next year's premium rate even though the National Health Insurance finances are expected to fall into deficit this year.
"The current account has remained in surplus over the past five years, and accumulated reserves as of the end of 2025 are about 30.2 trillion won. On top of that, government support next year will increase by about 1.1 trillion won from this year, and premium revenue is also expected to rise due to improved economic conditions such as the boom in the semiconductor industry. We considered these factors comprehensively."
-Isn't this freezing of premiums based only on confidence in the accumulated reserves, given that the current account is in deficit this year.
"It is true that a deficit is expected this year, but the National Health Insurance currently holds considerable accumulated reserves. We need to look comprehensively at this year's and next year's revenue and expenditure outlooks and the level of reserves. We judged that this is not a situation where fiscal management faces immediate problems. However, it is important to continue to pursue expenditure efficiency to secure fiscal sustainability going forward."
-How do you plan to secure finances without raising premiums.
"We plan to actively pursue expenditure efficiency. With the drug price system overhaul in Mar., we expect annual savings of about 270 billion won; with the June adjustments to specimen and imaging fees, about 2.6 trillion won; and with stronger management of false and improper claims, about 80 billion won. Combined, that is about 2.95 trillion won a year."
-How much is premium revenue expected to increase.
"Analyzing economic conditions, we expect wages and incomes to rise due to factors such as the boom in the semiconductor industry. Based on a comprehensive analysis of various economic indicators and data related to corporations, we reflected in the fiscal outlook that additional premium revenue of about 3.8 trillion won is expected."
-By how much will state support increase next year.
"About 1.01 trillion won was added to the government's general account. Next year's general account support is about 13.7 trillion won. In terms of the support level relative to expected premium revenue, it rises from 11.9% this year to about 12.3% next year. Support from the National Health Promotion Fund will be provided separately."
-Isn't that still short of the statutory 14% state support standard.
"The law requires the government to provide an amount equivalent to 14% of the expected premium revenue. However, raising it to 14% all at once is not easy in practice. We increased support by more than about 1 trillion won from this year, and we will continue to consult with fiscal authorities to raise the level of state support going forward."
-Does freezing premiums increase the burden on future generations.
"The National Health Insurance is different in nature from long-term insurance like the National Pension. The National Health Insurance has a strong nature of short-term insurance, with the premium rate adjusted around revenue and expenditure in the relevant year. Therefore, each year we determine the premium rate by comprehensively considering economic conditions, premium revenue, and medical expenditure."
-Was the decision to freeze the premium rate made by a vote.
"We did not vote. It was decided by agreement among the Commissioners."