Bern – The Swiss Federal Council has opted to maintain the country’s current health insurance premium calculation method, rejecting a proposal for a system mirroring tax prepayments. The decision, finalized December 12, 2025, impacts the roughly 99% of Swiss residents required to carry basic health insurance and follows a review of Postulate 22.4016,which aimed to address concerns over premium transparency and fairness. While proponents argued a prepayment system could offer greater financial predictability, the government concluded the administrative burdens and potential for market instability outweighed the benefits, ensuring continuity in a healthcare market representing over 12% of Switzerland’s GDP.
Switzerland’s Federal Council has decided against a fundamental overhaul of how health insurance premiums are calculated, a move that impacts millions of citizens and a significant portion of the country’s healthcare spending. The decision, made during a session on December 12, 2025, comes after a review of a proposal to introduce a prepayment system similar to tax calculations.
The proposal, stemming from Postulate 22.4016 Matter “Fair Health Insurance Premiums,” suggested replacing the current premium system with one based on advance payments and a final reconciliation, mirroring the approach used for income taxes. Under the proposed system, advance payments would be set to cover the anticipated costs of mandatory health insurance (OKP) per insurer and canton.
A report commissioned by the Federal Office of Public Health (BAG) concluded that the existing system has proven effective and provides transparency. The report noted that since the introduction of the Health Insurance Act (KVG) in 1996, premium increases have largely tracked the growth of costs financed by those premiums.
More Drawbacks Than Benefits
Implementing a prepayment system would present challenges for all stakeholders, according to the Federal Council. Policyholders would face uncertainty regarding potential refunds or additional payments at the end of the year. Insurers would be required to calculate both advance payments and actual premiums within a compressed timeframe, significantly increasing their administrative burden. Cantons would also encounter uncertainty regarding whether social benefits should be based on the advance payments or the final premium amount.
Furthermore, the regulatory authority would need to approve both advance payments and final settlements by the end of September, creating a substantial workload. Concerns also arose that some insurers might be tempted to set artificially low advance premiums to attract new customers, necessitating increased oversight.
The Federal Council determined that the disadvantages of transitioning to a prepayment system outweigh the potential benefits and has recommended maintaining the current calculation method. This decision reflects a cautious approach to altering a system that has, according to the government, demonstrated relative stability in a complex and highly regulated market.
Quelle: Schweizerische Eidgenossenschaft
