The 2025 Social Security budget is set to come into force in the coming weeks after being voted through by the Senate by 225 votes to 104 on Monday (February 17).
The budget is similar in many ways to measures relating to healthcare proposed by ex-prime minister Michel Barnier before he was ousted by a vote of no confidence in December 2024.
However there are some changes, including a rise in funding for hospitals and care homes.
Other inclusions in the budget do not necessarily stipulate a change that will immediately take place, but that discussions on legislation surrounding the topic can begin.
This is the case, for example, with ‘no-show’ penalty fines for missed appointments.
Measures based on future legislation are by no means certain to pass current prime minister François Bayrou does not hold a majority in the Assemblée nationale and may be voted down.
Below, we review the main changes, both agreed and proposed.
Funding increases for multiple areas
The budget predicts government spending in the sector to rise by 3.4%, reaching €265.9 billion annually by the end of 2025.
Higher than the 2.8% predicted by Mr Barnier’s budget, this is in part due to increased funding included in the new budget.
This includes an €1billion extra for public hospitals and an extra €300 million going towards EHPADs (care homes) - this is up from the €100 million extra proposed by Mr Barnier.
Changes elsewhere, some of which are detailed below, are forecast to result in savings of €4.3 billion.
Digital health cards on a ‘dedicated application’
The budget aims to introduce a widespread ‘digital healthcard’ (carte Vitale) in the upcoming year.
Little information is currently available, but French media is reporting that the card will work in conjunction with national ID Cards, but will be hosted on a ‘dedicated application’.
Previous plans suggested that the cards would be hosted through the France Identité application.
It is unclear if this 'dedicated application' for health cards will be open to those without a French national ID card, such as foreigners with a carte de Séjour.
Further information on the service – which will be optional to sign up to – will be given at a later point.
Currently, an official ‘digital healthcard’ application does exist, and is being trialled in around 20 departments.
Read more: Digital carte Vitale begins in many areas: where and how will it work?
Forced agreements for medical transport operators and radiologists
Taxi operators who work with state health insurer Assurance Maladie to provide medical transport must sign ‘expenditure control’ agreements with the state insurer to continue working in the role.
They will set out financial limits and map distribution alliances, to prevent operators driving too far to pick up/drop off patients or making too much profit from their role.
Similar measures will also be imposed on radiologists who work with the state insurer.
If Assurance Maladie fails to make €300 million in savings before the end of 2027, tariff cuts may be imposed on the sectors.
The insurer may also be able to refuse new transport agreements in certain areas if they believe it to already have sufficient medical transport.
Previous changes to medical transport operations have seen numerous protests by taxi drivers including ‘snail’ operations where they drive extremely slowly and block roads.
‘No-show’ tax for medical appointments
The budget allows for a ‘taxe de lapin’ (no-show tax) to be levied on patients who make a medical appointment but do not attend or cancel in advance.
It was originally suggested in 2024 by then-prime minister Gabriel Attal and would require separate legislation, which will include further details.
Mutuelles to cover more?
The prime minister promised that mutuelle top-up insurance would cover an extra €1 billion in healthcare costs, however the exact measure to provide for this will come via a later piece of legislation and is not included in the budget.
It means payments for mutuelle cover may increase as a response.
However, there are plans in the budget for Assurance Maladie and private insurers to share greater information to combat fraud.
Read more: Health insurance in France: See average mutuelle cost for retirees after new rises
Additional checks on prescriptions
The prescription of certain costly medicines and other state-reimbursed costs (such as medical transport) will come under extra scrutiny.
GPs and others who prescribe these medicines or additional requirements will need to agree that Assurance Maladie can investigate whether the prescription is appropriate.
If they do not, the reimbursement will automatically be rejected.
A full list of the medicines and activities subject to this rule will be provided at a later date after ‘consultations’ with doctors and other experts.
Read more: Doctors in France to receive €1,000 bonus for prescribing fewer drugs
Lower sick-pay cap
The government plans a change to the cap on the amount of sick-pay a worker can receive.
Workers can currently receive up to 50% of their daily pay from Assurance Maladie when on sick leave. This is topped up to 90% by their employer in some situations, up to a maximum of 1.8 times the daily minimum wage (SMIC).
The government will drop this to 1.4 times the daily SMIC, saving up to €400 million per year.
This change will not be immediate and will need to be passed via future legislation.
Read more: Visualise: Data on workers’ sick-leave days in France
Tax increase on sugary drinks, gambling… but not tobacco
Tax increases on sugary drinks and online purchases of lottery tickets and other approved forms of online gambling will come into force in the coming 12 months.
Higher rates of the so-called ‘soda tax’ will be increased on January 1, 2026, and gambling taxes on July 1, 2025.
The government hopes the combined taxes will raise around €300 million annually.
A planned increase on tobacco taxes – initially passed by the Senate and added to the original bill of Mr Barnier – was not included in the final bill.
Increase in employer healthcare contributions
Contributions paid on workers’ salaries will increase by €1.6 billion as the budget removes certain exemptions previously in force.
This is lower than the €4 billion increase in contributions Mr Barnier’s original budget planned for.
