France Doubles Caps on Medical Deductibles, Pushing Maximum Annual Patient Charge to €200

The French government is pressing ahead with a decree that will double the annual ceilings on two out‑of‑pocket healthcare charges: the franchise médicale (medical deductible) and the participation forfaitaire (fixed participation fee). According to a report from BFM Business, the decree is due to be published within days and will take effect two months later, meaning the new caps will apply from October.

Currently, insured patients face a deductible of 1 euro per box of medicine, paramedical procedure, or ambulance trip (capped at 4 euros per day for nursing or physiotherapy and 8 euros for patient transport) and a fixed fee of 2 euros per doctor’s visit, lab test, or X‑ray (capped at 8 euros per day). The annual limits on both charges were 50 euros each, meaning a patient could face a maximum of 100 euros in annual out‑of‑pocket costs under these two mechanisms. Under the new rules, each annual cap will rise to 100 euros, making the maximum combined exposure 200 euros per year – a sum that cannot be covered by most supplementary health insurance contracts.

The measure is expected to yield 500 million euros in extra revenue for the public health insurance system in the second half of 2026 and 740 million euros in a full year. The government argues the change is necessary to rein in rising health expenditure, but the advisory council of the national health insurance fund (Cnam) voted against the decree, with unions unanimously opposed and only the employers’ federation Medef and the Entrepreneurs movement voting in favour.

Budgetary Goals, Political Frictions, and Who Bears the Brunt of Higher Healthcare Costs

Budgetary arithmetic: why the government is pushing through the increase

The doubling of the caps is one of several measures designed to plug a growing hole in France’s social security accounts. Data from the Social Security Directorate (DSS) presented to the Cnam council shows that the cap increase alone will generate 500 million euros in 2026 and 740 million euros annually thereafter. In a context of stubborn public deficits, health spending is a prime target for savings, and shifting a share of costs onto patients – even a relatively modest one per person – adds up to a substantial fiscal contribution.

Notably, the government chose not to raise the per‑item charges (the 1 euro per box or 2 euros per consultation). By only lifting the ceilings, the pain is concentrated on heavier users of the system rather than spread across all insured persons, making it a regressive measure that disproportionately affects those with the greatest medical need.

Who loses most: chronic patients and the elderly

A DSS impact study highlights the unequal distribution of the extra burden. While the average annual out‑of‑pocket increase is estimated at 30 euros, the figure rises to 40 euros for patients with long‑term illnesses (affections de longue durée, ALD) and to 74 euros for the elderly. For a person with a chronic condition or multiple daily medications, hitting the 100‑euro ceiling on deductibles becomes more likely, and the same for frequent consultations.

This design has drawn sharp criticism from unions and patient groups, who argue that a summer‑time push through a simple decree – rather than a parliamentary debate – shields the government from democratic scrutiny while saddling the most vulnerable with higher healthcare costs.

The separate battle over reimbursement rates and what it means for insurers

The Cnam council also examined another proposal: a reduction in the share of costs covered by the public system for low‑ or moderate‑efficacy drugs, dental care, and other items. That measure, which would transfer roughly 1.2 billion euros of costs to complementary health insurers, was opposed by all members of the council – unions and employer representatives alike.

The employers’ side against it because, unlike the deductible caps that fall directly on individuals, a reimbursement cut for corporate insurance contracts would force companies to pay higher premiums. A council source told BFM Business, “It’s not surprising the employers oppose this time – deductibles don’t hit companies, but this will.” While the government has not yet advanced that measure, the combined push reveals a clear strategy: off‑load more of France’s healthcare bill onto patients and private insurers, gradually eroding the generous universal coverage that has long been a pillar of the French social model.

What French Households Should Do Before the October Increase

Check your current out‑of‑pocket situation. If you already come close to or exceed the 50‑euro annual caps on medical deductibles or participation fees, you will almost certainly reach the new 100‑euro limits. Review your last twelve months of healthcare spending to estimate the extra cost.

Re‑examine your complementary health insurance. Most contrats responsables do not reimburse the franchise médicale or participation forfaitaire. With the caps doubling, the gap left by your insurer becomes larger. Ask your mutuelle whether any adjustments to your plan could partially offset the higher out‑of‑pocket, though in practice few policies cover these charges.

Budget for the change, especially if you are an elderly or chronic‑disease patient. The DSS estimates show an average annual increase of 74 euros for the elderly and 40 euros for ALD patients. For a pensioner on a tight budget, that extra 74 euros could mean sacrificing other essentials. Plan for the 200‑euro worst‑case scenario, even if your actual burden is likely lower.

Note the October start date. The increase will apply two months after the decree’s publication in the Journal officiel, which is expected within days. The first months of higher caps will hit during the final quarter of 2026.