National health insurance subsidy for 8 years falls short of KRW 13 trillion... I won't be able to meet the legal standards next year either.

As the government set aside less government subsidies to finance health insurance than the legal standard, the cumulative shortfall over the eight years from 2020 to 2027 was found to exceed 13 trillion won.

In next year's budget, only 12.3%, which is less than the statutory support rate of 14%, was reflected, resulting in a shortfall of more than 1.6 trillion won. As a result, the National Assembly Budget Office urged the government to comply with legal standards and prepare a specific implementation plan.

According to the '2027 Budget Committee Analysis Report' published by the National Assembly Budget Office on the 5th, the 2027 budget for support of health insurance subscribers (general account) compiled by the Ministry of Health and Welfare is KRW 11.7923 trillion.

This is a 9.4% increase from 2026, but only accounts for 12.3% of the expected insurance premium income for that year (KRW 95.9208 trillion).

Article 108-2 of the current National Health Insurance Act specifies that the state shall support from the national treasury in the general account an amount equivalent to 14% of the expected revenue from health insurance premiums for the year within the budget each year. However, the actual government support rate is 11.5% in 2020, 11.5% in 2021, 11.9% in 2022, 12.0% in 2023, 12.1% in 2024, 12.1% in 2025, 11.9% in 2026, and 12.3% in the 2027 budget plan. It stayed in the 11-12% range.

For this reason, the total shortfall resulting from failure to maintain the statutory support rate (14%) for eight years from 2020 to 2027 amounts to KRW 13.0731 trillion. This amounts to 43.3% of the cumulative health insurance reserve of 30.2217 trillion won as of the end of 2025. Looking at the 2027 budget alone, an additional 1.6366 trillion won must be allocated to meet the legal standard of 13.4289 trillion won.

The National Assembly Budget Office pointed out that the government has been arbitrarily reducing the amount of support depending on financial conditions, based on phrases such as the scope of the legal budget and equivalent amount. Even though the National Assembly requested corrections to comply with the statutory ratio every time it reviews the financial year from 2023 to 2025, annual under-allocation is recurring.

Health Insurance's financial situation is becoming increasingly tight. As a large amount of health insurance finances were invested in government health care policies, such as the operation of the emergency treatment system and the restructuring of tertiary general hospitals due to recent legislative conflicts, the current balance surplus sharply decreased from KRW 4.1276 trillion in 2023 to KRW 1.7244 trillion in 2024 and KRW 499.6 billion in 2025.

The National Assembly Budget Office ordered that if it is difficult to meet the legal standards at once, a specific implementation plan should be established by presenting target support rates by target period and year and reflecting them in the medium-term financial plan.

A close financial review of the decision to freeze health insurance premium rates for 2027 was also requested. The Ministry of Health and Welfare froze the health insurance premium rate for 2027 at 7.19%, the same as the previous year, through the Health Insurance Policy Review Committee in September 2026. It cited the surplus over the past five years, accumulated reserves of around 30 trillion won, and the prospect of additional income due to the semiconductor boom in 2026 (approximately 3.8 trillion won).

However, the report pointed out that the increase in income due to semiconductor performance bonuses is likely to be a one-off factor. In addition, he emphasized that it is difficult to confirm the specific point in time the additional revenue is based on and how it is reflected in the expected revenue amount in the 2027 budget, and that it is necessary to comprehensively reexamine the spending factors that will increase due to expansion of coverage and support for local essential medical care.

The sunset issue of government support regulations was also cited as a key challenge. The government support regulation for health insurance is a temporary regulation that will only be in effect until December 31, 2027, according to the supplementary provisions of the National Health Insurance Act. Since its introduction in 2007, the deadline has been extended four times and has continued as a temporary measure.

The National Assembly Budget Office suggested that since health insurance support is an ongoing project, it is necessary to revise the law to end the temporary provision and make the basis for support permanent. The explanation is that the standard for calculating subsidy should be clarified from the expected income amount to the settlement amount, and the predictability of the amount of support should be increased by institutionalizing the procedure for settling the difference between the estimate and the settlement.