Franchises médicales and participations forfaitaires are the subject of a fierce political battle as the new academic year begins in 2025. The 35-member Conseil de l'Assurance Maladie, which includes 26 union and employer representatives, voted against the government measure on Thursday. However, François Bayrou's government insists on passing the reform by regulation, despite strong opposition from French healthcare organizations.
This measure is part of the government's plan to reduce health insurance expenditure by 5 billion euros by 2026. According to the draft decrees examined, the current amounts would be doubled: the medical deductible would rise from 1 to 2 euros per box of drugs, from 1 to 2 euros per paramedical act, and from 4 to 8 euros per medical transport. At the same time, fixed contributions for medical consultations would increase from 2 to 4 euros per procedure.
The annual ceiling for these medical deductibles would also be doubled, from 50 to 100 euros per patient per year. In practical terms, this would mean that a French person requiring regular medical care could pay up to 200 euros a year out of pocket, compared with the current 100 euros. This increase would particularly affect patients suffering from chronic illnesses or requiring regular medical follow-up.
Controversy is growing over the timetable chosen by the executive. According to information gathered, the Social Security department was planning to publish the decree doubling the annual ceilings as early as Thursday evening. This haste comes just a few days before the vote of confidence requested by François Bayrou for September 8, 2025.
The unions and the chairman of the health insurance board had unsuccessfully asked the government to postpone this decision, given the risk of a possible fall of the executive. Sophie Binet, General Secretary of the CGT, denounced this "shameful" procedure and called on the Prime Minister to back down: "You can't, at the same time, say 'I submit to a vote of confidence' and, at the same time, go ahead on the sly with such important measures".
This reform is causing concern among patient associations and healthcare professionals. The MG France union describes the government's method as "absolutely inadmissible" and denounces a "democratic denial". For Féreuze Aziza, of the France Assos Santé association, this measure will "lead people to forego care because they will have no choice, because it means more and more out-of-pocket expenses".
In the Île-de-France region, where the cost of living is already high, this increase could have a particular impact on low-income households and chronically ill patients. Beneficiaries of the Complémentaire santé solidaire, the AME, minors and disability pensioners remain exempt from these deductibles.
The government justifies this reform by the need to "empower" patients and generate several hundred million euros in savings. According to official estimates, doubling medical deductibles would save the French health insurance system around 1.5 billion euros a year.
However, this argument is open to debate.UNSA points out that medical deductibles and fixed contributions had already been doubled by 2024, without significantly reducing medical consumption. "Far from having reduced medical consumption, these increases have had only one concrete effect: to tax patients even more," the union denounces.
FNATH, the French federation of people with industrial injuries and disabilities, is firmly opposed to this measure, which it sees as a social injustice. According to this association, the deductibles are not proportional to income, and therefore weigh more heavily on low-income earners and the chronically ill.
It remains to be seen whether this controversial reform will survive the vote of confidence on September 8. Should the Bayrou government fall, the fate of these decrees on medical deductibles could be called into question, leaving uncertainty hanging over the future of the French healthcare system and its financing.
