The Non-Coverage of Complementary Health Insurance in France in 2019 Initial Findings of the European Health Interview Survey (EHIS)

Pierre A. (IRDES), in collaboration with Rochereau T. (IRDES)

Questions d'économie de la santé (Issues in Health Economics) n° 268 - May 2022

QES n° 268

Although the number of individuals without complementary health insurance is at its lowest level -having dropped from almost 14% of the population aged 15 years and over in 1996 to 3.6% in 2019-, the current organisation of complementary health insurance and recent reforms aimed at employed individuals leaves part of the population by the wayside. Hence, the segment of the population that does not have an employer complementary health insurance policy and does not benefit from the Complementary Health Solidarity (CSS, Complémentaire Santé Solidaire) has to pay the high premiums of individual policies, in particular the elderly. We describe the 2.5 million French persons without complementary health insurance in 2019, based on the findings of the 2019 European Health Interview Survey (EHIS). In 2019, freelance workers, the unemployed, and economically inactive persons were most often uninsured by a complementary health insurance. The poorest retired persons, who pay high premiums in proportion to their financial resources, were also most often uninsured. The employer complementary health insurance mandate implemented in 2016 has resulted -by reducing inequality coverage among private-sector employees- in a reduction in the number of uninsured persons among the less well-off middle classes. Nevertheless, the individuals' economic and social situation remains the main determinant of being insured, due to the cost of policies but also to the complexity of administrative procedures.

See also Questions d'économie de la santé n° 268 in French: L'absence de couverture par une complémentaire santé en France en 2019. Premiers résultats de l'Enquête santé européenne (EHIS).