Three million people are not covered by complementary health, mainly low-income people such as precarious workers, unemployed or inactive, the Dress tells Wednesday.
Nearly 5% of the French population, about three million people, are not covered by complementary health insurance despite the generalization of business contracts, according to a publication released Wednesday by the Drees.
Low-income people still barely covered
These French without mutual "are mainly low-income people: precarious workers, unemployed or inactive," notes the statistical service of social ministries in the second edition of its Panorama of complementary health .
The Drees recalls that in 2014, 16% of the unemployed and 9% of homemakers said they were not covered, against 2% to 3% of civil servants, private employees and pensioners. The generalization of the company supplement, which came into effect in 2016, has changed little this situation: "The first estimates indicate that the rate of uninsured would only drop by one point" because of this measure.
Helpers unknown
Passed between the cracks of collective agreements, people without supplementary health coverage are also potential beneficiaries of safety nets. Thus, half "could in principle claim the CMU-C (complementary universal health cover) or the ACS (aid to the payment of complementary health)", calculates the Drees, which points "a misunderstanding [of these] help devices ".
The rate of non-use of the CMU-C was estimated between 34% and 45% in 2017, ie 2.8 to 4.5 million people. For the ACS, this rate was estimated between 41% and 59%, ie 1.1 to 2.3 million additional people. If they do not assert their rights, these insured persons can however benefit from a complementary health, individually, by their employer (low wages, partial time) or as having-rights (spouse, parent).
Market concentration
The government decided to amalgamate CMU-C and ACS on November 1, 2019, which will become a "contributory" CMU with a financial contribution of up to € 30 per month, in order to increase recourse rates. In addition, the Drees confirms the concentration of the complementary health market: 474 organizations carried out this activity in 2017, 18 fewer than in 2016. In 2001, there were 1.702.
Since then, "the number of mutuals has been divided by four" (346 in 2017) and "the number of pension institutions by two" (25 in 2017), while that of insurance companies has declined "in proportions least "(103 in 2017). A "huge movement" of "mergers and removals" caused by "regulatory requirements", especially financial reserves, and exacerbated competition due to the almost total coverage of the population.
In this increasingly competitive landscape, insurance companies have come out on top: their market share has increased from 19% to 31% of the contributions collected (totaling 35.7 billion euros in 2017). This growth was mainly to the detriment of mutuals (-12 points to 51%) and more marginally to provident institutions (-3 points to 18%).