Health insurance premium. First reading of four draft changes in the Sejm

Government projects are intended to simplify the rules for calculating health insurance contributions and reduce their amount for some entrepreneurs. The first one, prepared by the Ministry of Health, predicts that revenues will come from sales fixed assets (e.g. real estate) will not be included in the basis for calculating health insurance contributions. The provisions resulting from changes to the Act on health care services financed from public funds are scheduled to enter into force on January 1, 2025.

Autocorrect for this project, prepared by Ministry of Financeassumes a reduction in the minimum basis for health insurance contributions for entrepreneurs to 75% from 2025. minimum wage. According to the government, approximately 934,000 people will benefit from the change. entrepreneurs: people with the lowest income or loss will save up to approx. PLN 105 per month. The government assures that funds have been reserved in the 2025 budget to compensate for the revenues up to National Health Fund reduced after the health insurance premium was reduced. It was noted that the cost of this solution for the state budget is approximately PLN 945 million. Another government project, prepared by the Ministry of Finance, concerns changes to the rules for calculating health insurance contributions for entrepreneurs from 2026. The draft amendment to the Act on health care services financed from public funds and certain other acts introduces a two-element basis for calculating health insurance contributions for those paying tax according to the tax scale, flat or lump sum tax on recorded income. According to the government, approximately 2.45 million entrepreneurs will benefit from the reform. The regulatory impact assessment estimated that in 2026, revenues to the National Health Fund from health insurance contributions will decrease by PLN 5,854 million. In the perspective of 2034, this will be PLN 59 billion 471 million less funds from which the health care system is financed. According to this project, the flat-rate part of the contribution will amount to 9%. from 75 percent minimum wage, and the second part will be calculated on the surplus of income above 1.5 times the average monthly salary of entrepreneurs settling the tax scale or flat tax (rate 4.9%). In the case of entrepreneurs settling a lump sum, the second part of the contribution will be calculated on the surplus of revenues above 3 times the average monthly salary (rate of 3.5%). The project also assumes a reduction of the contribution to 9%. with 75 percent minimum wage (currently 9% of the minimum wage) for entrepreneurs paying tax in the form of a tax card. The government project abolishes the possibility of settling paid health insurance contributions in income tax.

The Minister of Health, Izabela Leszczyna, referring to the proposals of the Ministry of Finance, noted that it is difficult to expect her to support projects that reduce the financing of health care. She added that she had the word of the Minister of Finance, Andrzej Domański, that every million by which the National Health Fund's revenues would be reduced would be compensated by a subjective subsidy from the state budget to the National Health Fund. – I have the word of the Minister of Finance (Andrzej Domański) that every, not even a billion, but a million, loss from the National Health Fund's revenues will be compensated with a subjective subsidy from the state budget to the National Health Fund – said the Minister of Health.

When asked if she was not afraid that there would be a shortage of money in the state budget in the coming years, she replied that politics is also about trust. – Especially the trust of ministers who are in one government – she noted.

– I have talked to the Minister (of Finance, Andrzej) Domański on this subject many times, also in the presence of the Prime Minister. I am sure that the funds resulting from this loss in health insurance premiums will go back to the National Health Fund – added Leszczyna.

PLN 4 billion has been reserved in the 2025 budget to compensate for the reduced revenues to the National Health Fund after the reduction of the health insurance premium.

The parliamentary bill Poland 2050 from June, to which an amendment was submitted in July, concerns the rules for calculating health insurance contributions paid by entrepreneurs and employees. The project proposed that the basis for calculating the contribution would be the average monthly salary in the enterprise sector (in the third quarter of the previous year). The health insurance contribution would be 4%. assessment basis if the total amount of revenue, income, remuneration, remuneration or benefits in a calendar year does not exceed PLN 85,000. zloty. If it exceeds 85 thousand PLN, but will not be higher than PLN 300,000. PLN, the contribution will be 7%. dimension basis. After exceeding 300 thousand PLN, the contribution will be 9.4%. dimension basis. The Poland 2050 project assumes that when during the calendar year the amount of contributed income exceeds PLN 85,000. or PLN 300,000, the insured person will pay the premium for the previous months. The total loss of National Health Fund revenues was estimated in the Poland 2050 project at approximately PLN 25-30 billion. The changes introduced by the amendment to the Act on health care services financed from public funds and certain other acts would be in force from January 1, 2025.

However, the PiS parliamentary bill from March changes the rules for determining the basis for calculating health insurance contributions for entrepreneurs and restores the possibility of deducting health insurance contributions from personal income tax (7.75% of the basis for calculating the contribution). The project assumes that the basis for calculating the health insurance premium will be a fixed lump sum fee. PiS MPs estimated the cost of changes for the state budget at PLN 9 billion. The changes introduced by the amendment to the Act on health care services financed from public funds and the Personal Income Tax Act would be in force from January 1, 2025. Health care is financed in the vast majority of revenues from health insurance contributions. The draft NFZ plan for 2025 assumes that revenues from contributions will amount to over PLN 173.1 billion (87.5% of total revenues).