In the Draft Proposal for the Amendment to Supplement Certain Provisions of the Health Insurance Law (HI Law) currently being solicited by the Ministry of Health, it is proposed to amend and supplement certain provisions regarding the mandatory participants in the Health Insurance Law as stipulated in Article 12 of the Health Insurance Law.
Article 12 of the HI Law stipulates the eligible participants in the Health Insurance Law, which includes the group of employees and employers contributing to health insurance; the group of participants whose health insurance is covered by Social Insurance Agency; the group of participants whose health insurance is covered by the state budget; the group of participants whose health insurance is partially subsidized by the state budget; the group of participants who participate in health insurance under family policies and other groups as prescribed by the Government.
Article 12, Clause 1 of the HI Law (2014) stipulates the group of employees and employers contributing to health insurance, including:
a) “Employees working under labor contracts with indefinite terms; labor contracts with definite terms of at least 3 months or more; Employees who are enterprise managers receiving wages; officials, civil servants, professional workers (hereinafter referred to collectively as employees;
b) Non-specialized personnel at communes, wards, townships as prescribed by law.”
In the draft currently being solicited, the Ministry of Health proposes to amend and supplement the provisions of point a, Clause 1, Article 12 regarding the mandatory participants in health insurance to ensure uniformity and consistency with the provisions of the draft Law on Social Insurance currently being submitted to the National Assembly, including:
– Employees working under labor contracts without definite terms; labor contracts with definite terms of at least 1 month or more;
– Enterprise managers, inspectors, representatives of state capital shares, representatives of capital shares of companies and parent companies, managers operating cooperatives, federations of cooperatives receiving wage;
– Business owners of businesses subject to business registration requirements.
– Supplementing foreign citizens working in Vietnam under a labor permit or a professional practice certificate or a professional practice license issued by competent authorities of Vietnam and having a labor contract with a definite term of at least 12 months or more with employers in Vietnam;
– Employees as prescribed in point a of this Clause working on a non-full-time basis, belonging to the mandatory participants in health insurance as prescribed in points c, d of Clause 1, Article 12.
The Ministry of Health also proposes to amend and supplement Clause 5 regarding self-paid health insurance group, including supplementing persons living, working, persons being nurtured, cared for in charity organizations, religious organizations, Vietnamese individuals without personal identification papers, foreign individuals living in Vietnam who do not belong to the subjects already stipulated in the Law, employees during leave without pay or postponement of labor contracts for self-paid or participating in the form of family policies.
The draft also updates the mandatory participants in health insurance who are already stipulated in Government Decrees into the group of participants in health insurance in Clause 3, Article 12 of the Health Insurance Law, such as People in An toan khu cach mang in the resistance war against France and the U.S. currently permanently residing in An toan khu cach mang communes in the resistance war against France and the U.S. have been updated their information into the national population database, population database on residence.
According to the Ministry of Health, this amendment and supplementation may help maintain and increase the number of participants in health insurance, thereby increasing revenues for the Health Insurance Fund, increasing funds for health care BHYT for medical treatment facilities.
For example, in 2023, there are about 2 million households registered their businesses, if only this group participated in health insurance, the Health Insurance Fund may increase nearly VND 2,000 billion each year.
In the first quarter of 2023 in Binh Duong province, there were more than 36,300 employees on leave without pay or suspended labor contracts. When these subjects are stipulated to continue to participate in health insurance, it will help maintain the stability of participants and revenue of the Health Insurance Fund.
The Ministry of Health also evaluates that participants in health insurance benefit when they are financially secured and reimbursed by the Health Insurance Fund in case of illness. By the end of 2023, the population of Vietnam is over 100 million. The total number of participants in health insurance in our country is over 93.6 million people, corresponding to the coverage rate of 93.35% of the population. Participating in the Health Insurance Program has contributed to reducing household expenditure on healthcare.
The Ministry of Health expects to submit the Law amending and supplementing certain provisions of the Health Insurance Law to the 7th session of the 15th National Assembly in May 2024.
