A National Health Insurance (NHI) premium exemption for children younger than six, reported to be proposed by the Chinese Nationalist Party (KMT) caucus, should be carefully evaluated, the Ministry of Health and Welfare said yesterday.
The Chinese-language United Daily News yesterday reported that the KMT’s think tank suggested amending the Child and Juvenile Welfare and Rights Protection Act (兒童及少年福利與權益保障法) to exempt children aged six or younger from NHI premiums, to help address Taiwan’s low birthrate.
The article quoted KMT Legislator Hung Meng-kai (洪孟楷) as saying that most KMT lawmakers supported the change, and it would be proposed by the party caucus as a priority bill to ease the financial burden on young parents.
Photo: CNA
The ministry said that the government already provides subsidies to partially or fully cover premiums for economically disadvantaged families, ensuring universal access to healthcare.
As the reported KMT proposal would involve fiscal expenditure, the ministry urged lawmakers to conduct a comprehensive evaluation of overall childcare policies and deliberate it carefully.
The government’s subsidies cover low-income and middle-to-low-income households with children and adolescents younger than 18; indigenous peoples younger than 20, or aged 55 or older enrolled under “Category 6, Type 2”; and people with disabilities, it said.
Moreover, the government provides medical subsidies for all children aged three and younger, and economically disadvantaged children younger than 18, it said.
An average of NT$1.7 billion (US$54.09 million) per year was allocated for subsidies for children aged three and younger, including outpatient and inpatient copayments, between 2020 and 2024, benefiting over 8.88 million total visits, the ministry said.
Children younger than 18 from low-income or middle-low-income households, those under protective care or placement, and those with developmental delays, premature births or rare diseases are also eligible for medical subsidies, it said.
The subsidies for children younger than 18 also include those with catastrophic illness or who are eligible through assessments by local government social workers, it added.
The subsidies cover out-of-pocket hospitalization expenses and nursing fees beyond NHI coverage, as well as fees for early intervention assessments and therapeutic training, the ministry said.
An average of NT$150 million per year was allocated for the subsidy, to cover an average of 18,000 visits per year.
Taiwan College of Healthcare executive chairman Hung Tzu-ren (洪子仁) said a child’s monthly NHI premium is linked to their parents’ economic situation, meaning that children from wealthier families pay more.
The system was established in “the spirit of mutual aid,” with the economically advantaged contributing more to help the disadvantaged, Hung said.
If the KMT proposal exempts parents from paying premiums for all children younger than six, wealthy families would be benefiting from the kind of subsidies originally intended for economically disadvantaged families, he said, adding that the change would be against the “ability-to-pay principle” and the spirit of mutual aid.
Furthermore, the exemptions would create a budget crowding-out effect, which would be detrimental to the NHI system’s long-term financial sustainability, he said.
There are many solutions to address the nation’s declining birthrate, including enhancing birth subsidies and creating more childcare-friendly environments, but creating across-the-board premiums exemptions for children younger than 6 — potentially harming the NHI system’s core spirit and fiscal sustainability — should be carefully considered, Hung said.
Additional reporting by CNA
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