On 23 July 2026, the French government announced that the annual ceiling on two small out-of-pocket health charges would double, from €100 to €200. On 20 August, the Health Minister told Le Figaro that the doubling had not been well understood and that it had appeared brutal. Four days later, a draft decree seen by AFP set the new ceiling at €140 instead.
The government therefore gave up €60 in less than a month. This may look like a minor retreat over a small sum, but the episode is more revealing than it appears. It shows how a government without a parliamentary majority now makes decisions, and why health spending has become so difficult to reform in France.
The charges in question
Two deductions apply at the very end of the French reimbursement process. A flat charge of €2 applies to each consultation, radiology exam and laboratory test. A separate deductible of €1 applies to each box of medicine and each paramedical act, and €4 to each medical transport. Each of the two has been capped at €50 per year since it was created, which gives a combined maximum of €100.
These charges are unusual for one reason. Complementary insurers are legally prohibited from reimbursing them. Almost everything else in the French system can be passed on to a private insurer, but these two charges cannot. They are uninsurable by design, because their stated purpose is to make patients feel a small cost each time they use care.
The draft decree does not change the unit amounts. It raises each ceiling from €50 to €70, which gives a combined maximum of €140, from 1 October. According to AFP, the draft also provides that the amount will be revalued every one or two years in line with inflation. The Health Ministry estimates the average impact at €10 per year for the people who pay these charges, and at around €2 per month for patients with a recognised long-term condition. About 18 million people who are currently exempt, including minors, pregnant women and beneficiaries of the two means-tested schemes, will remain exempt.
Why the government is looking for savings
The financial context is straightforward. The deficit of the health branch is projected at €13.8 billion for 2026 and €15 billion for 2027, and French public debt exceeds 110% of GDP. In a July interview with Paris Match, the Prime Minister said that he was not optimistic about keeping the overall public deficit at 5% of GDP in 2026, and he blamed the war in Iran and inflation.
Budget debates were due to open in the autumn and the government was openly looking for savings. This part of the story is ordinary. What deserves attention is where the government chose to look, and the method it used.
Parliament had already rejected the measure
This is the most important element of the episode. In November 2025, during the debates on the 2026 social security financing bill, the National Assembly deleted the article that would have doubled the unit amounts of these same charges. Eleven of the twelve parliamentary groups voted in favour of deletion. The largest group of votes came from the far-right Rassemblement National, followed by the radical left, the Socialists, the Greens and part of the traditional right. Only twenty-three deputies voted against deletion, and all of them belonged to the three groups supporting the government. The President’s own group mostly abstained. There was therefore no majority for the measure anywhere in the chamber, including among the government’s own supporters.
The Socialists, whose abstention was keeping the government in office, presented the abandonment of the measure as a concession they had obtained. On 4 December 2025, the Prime Minister told the Assembly that his government would not force through measures for which there was no clear majority. Eight months later, the same government adopted a variant of the same measure by decree.
The two versions are not identical, and the difference matters. Parliament rejected an increase in the amount paid for each box of medicine and each consultation. The decree leaves those amounts unchanged and raises the annual ceiling instead, so that patients continue to pay for longer before the protection applies. The technique is different, but the effect on patients points in the same direction.
According to Public Sénat, the Prime Minister’s office viewed the regulatory route favourably because it kept the measure away from parliamentary conflict. This is a revealing statement of the underlying problem. When a chamber is blocked, the remaining space for government action is the space where the chamber does not intervene.
What the different actors say
Opposition to the July announcement was broad, and it did not follow the usual left-right division.
The Socialist deputy Jérôme Guedj, who had negotiated the earlier compromise, described the increase as unacceptable and challenged the government’s calculation, arguing that a genuine inflation adjustment would produce a figure closer to €67 per ceiling than €70. He also called the original doubling a casus belli for those who had negotiated and voted for the 2026 budget. For a government that depends on Socialist abstention to survive, this is a serious warning.
The CGT called the measure a tax on the sick and criticised the use of a decree to avoid Parliament, particularly since the board of the national health insurance fund had expressed its opposition in July. The president of France Assos Santé told Le Monde that financial measures of this type do not address the real problems and that they penalise the people who need care most.
Health professionals were more divided, and this is where the debate becomes interesting. The head of the main pharmacists’ union rejected the measure, but he also accepted the underlying argument, saying that returning to balanced accounts was obviously necessary. Opposition to this particular instrument is therefore not the same as opposition to budget consolidation.
The problem of public opinion
Polling shows the impasse clearly. An Elabe survey for Les Échos in July 2026 found that 84% of respondents considered the reduction of public debt to be urgent, the highest figure recorded since 2023. The same survey found that 76% rejected a reduction in dental care reimbursement and that 60% rejected the doubling of the deductibles. An earlier Elabe poll had measured opposition to an increase in the deductibles at 72%.
These results are not contradictory. A large majority accepts the diagnosis but rejects each proposed solution, because every solution identifies the people who will bear the cost. The same survey found that 81% considered it unfair to ask pensioners to contribute more than working-age people, which closes another possible route. Governments in this situation can either try to persuade, which requires political capital, or reduce the visibility of the decision, which does not.
What the retreat actually achieved
Seen in this light, the sequence looks less like a defeat than an exchange. The government abandoned the headline figure. It had already been forced to withdraw the measure once in Parliament, and the previous government had been removed from office before it could apply a similar plan. The €60 was the price of avoiding a second confrontation.If the draft is confirmed in its current form, what the government kept is more significant than what it gave up. A ceiling that had remained unchanged for two decades would become a ceiling that rises automatically with prices. Each future increase would then take effect without an announcement, without a vote, and without any moment at which someone has to defend it publicly. This is a structural change presented as a technical adjustment.
A question for European readers
The problem is not specific to France. Every member state facing an ageing population and limited public finances encounters the same gap between general support for consolidation and rejection of each concrete measure. Some countries have responded by making the ceiling redistributive: Belgium links the maximum annual out-of-pocket amount to household income, and the Netherlands combines a substantial deductible with an allowance for lower-income households. The French ceiling, by contrast, is the same for a minimum-wage earner and for a senior executive, and indexation would protect it from political revision rather than adjust it to income.
The real question is therefore not whether €40 per year is affordable. It is whether a system can continue to transfer costs through instruments that no one has to defend, and how long that approach can remain politically sustainable.
