Adjusting policies, expanding health insurance coverage

The promulgation of Decree No. 188/2025/ND-CP is considered a concrete and substantial step forward in implementing the Law amending and supplementing a number of articles of the Law on Health Insurance.

Assessing the condition of a child patient at the ENT Hospital. (Photo: ANH PHUONG)

Accordingly, there will be timely policy adjustments to suit the two-tier government model, supporting the expansion of participants; this is an important foundation to gradually move towards the goal of universal health insurance coverage.

Health insurance (HI) is one of the major social policies with deep humanity and community sharing, which has been directed and implemented by the Party and the State from an early stage. However, recent practice shows that in order to expand the coverage of HI, especially among vulnerable groups such as the poor, near-poor, informal workers, students, etc., there are still "bottlenecks" in policy. One of the reasons is that the support policy is not really comprehensive and close to specific target groups.

To move towards universal health insurance coverage, the National Assembly passed the Law amending and supplementing a number of articles of the Health Insurance Law and the Government issued Decree No. 188/2025/ND-CP, dated July 1, 2025, detailing and guiding the implementation of a number of articles of the Health Insurance Law. Decree No. 188/2025/ND-CP aims to remove, amend and supplement difficulties in the implementation of the Health Insurance Law; at the same time, expand coverage policies, making them closer to reality so that people can actively participate in health insurance.

The Decree consists of 5 chapters with 29 articles, focusing on regulations on health insurance participants, adding specific groups as well as using national population data to identify poor households and the right support subjects to help avoid duplication, errors and shorten information processing time.

According to the Director of the Health Insurance Department ( Ministry of Health ) Tran Thi Trang, one of the highlights of the Decree is to expand the subjects participating in health insurance by adding a new group of subjects supported by the budget and issued health insurance cards, with special attention to the disadvantaged, people in near-poor households, households with average living standards in difficult areas, and informal workers.

According to the new regulations, the level of health insurance support for students has been adjusted to increase by at least 30% to 50% from the State budget, to encourage this young population group to participate in the health insurance system.

In addition, support the health insurance premium for vulnerable groups; adjust the health insurance premium support level in a flexible manner, creating conditions for localities to supplement support from the local budget, welfare funds or other legal sources. The Decree also expands the scope of direct payment in cases where health insurance participants do not have time to complete procedures at the initial medical examination and treatment facility or emergency care outside the line.

Regulations on payment mechanisms for medical examination and treatment costs for subjects in remote, border, island areas or cases of force majeure have also reduced distance, time, and geography, helping to provide more flexible support for people in these areas.

According to the new regulations, the level of health insurance support for students has been adjusted to increase by at least 30% to 50% from the State budget, in order to encourage this young population group to participate in the health insurance system. The Decree has expanded and added groups of subjects that are fully or partially supported by the budget, such as: people who donate body parts while they are still alive; people who donate bodies; bomb and mine victims; low-income people's and elite artisans; citizens living in safe revolutionary zones; elderly people aged 75 and over without pensions or social insurance benefits, etc.

On the policy front, Decree 188/2025/ND-CP is a big step forward to remove the biggest barrier in achieving the goal of universal health insurance by supporting the cost of health insurance participation for groups of detainees, people serving sentences, etc. Including these specific groups of subjects in the budget support clearly demonstrates the role and policies of the Party and State for the people and closer to the people, and is also the key to expanding coverage, so that no one is "left behind" due to lack of flexibility in policy access.

Decree 188/2025/ND-CP demonstrates the political determination to expand universal health insurance; at the same time, it affirms the commitment of the Party and State in implementing social security policies. With more than 94% of the population participating in health insurance, the goal of universal coverage is approaching.

Deputy Minister of Health Tran Van Thuan

Decree 188/2025/ND-CP has demonstrated the determination of the Party and State in perfecting the universal health insurance system. However, reality shows that there are still many difficulties and challenges such as: Correctly identifying vulnerable groups, making lists, and assessing support levels are still difficult when the data management system has not been updated promptly; informal workers account for nearly 60% of the country's workforce and most of these groups of workers do not have labor contracts and have unstable incomes...

Discussing this issue, Ms. Tran Thi Trang stated: Decree 188/2025/ND-CP has stipulated the provisions in the implementation phase of the arrangement and organization of the two-level local government apparatus. Specifically, people participating in health insurance who are determined by competent authorities to be subjects of health insurance paid by the State budget or supported by the health insurance premium before the effective date of this Decree (July 1, 2025) and change subjects, continue to receive support from the State budget to pay health insurance and enjoy the rights determined in the document of competent authorities until the expiration of the effective period or when the subjects are re-determined according to the new document.

The general principle is not to eliminate or disrupt the existing primary health care system but to reorganize it in accordance with the new government model, ensuring that people continue to have equitable and convenient access to health care services.

Deputy Minister of Health Tran Van Thuan affirmed that Decree 188/2025/ND-CP demonstrates political determination in expanding universal health insurance; at the same time, affirms the commitment of the Party and State in implementing social security policies. With more than 94% of the population participating in health insurance, the goal of universal coverage is approaching.

However, it is necessary to continue to remove “bottlenecks”, including informal workers, people who have not registered for temporary residence, and people in remote areas. In fact, many freelance workers have not participated in health insurance because they do not have the financial means or lack access to information. Therefore, localities need to focus on communication work to bring policies closer to the people.

By the end of June 2025, there were 12,617 medical facilities nationwide that organized health examination and treatment under health insurance. There were a total of 94,730,851 health examination and treatment visits under health insurance, an increase of more than 6.5 million visits over the same period last year; with health insurance expenditures of more than 76 trillion VND, accounting for 52.43% of the estimated expenditure for health examination and treatment in the year.

THANH MAI

Source: https://nhandan.vn/dieu-chinh-chinh-sach-mo-rong-bao-phu-bao-hiem-y-te-post903903.html