2026 Social Security Funding Bill : A bill which undermines access to healthcare and family support policies.
On 14th October during the ministers’ committee, the government presented its Social Security Funding Bill (PLFSS) for 2026. In a context of falling birth rate and ageing of the population, the bill is proposing major economies on the expenditure on health, further undermining access to healthcare and sapping family support policies.
A general reduction in healthcare expenditure which threatens the access and quality of healthcare
The proposed bill aims to reduce its deficit to 17.5 billion euros in 2026, after the 23 billion euros deficit in 2025. To that end, the uplift of the national target for health insurance expenditure (ONDAM) will be limited to 1.6 % (compared with +3.4 % in 2025). This increase will be less than the natural increase in expenditure on health insurance associated with the ageing of the population. In order to achieve the 7.1 billion euros saving, the bill contains several significant measures:
- Limitation of the maximum duration of sick leave;
- Doubling of set contributions and medical exemptions (sum payable by patients);
- “Transfer” of expenditure to mutual benefit insurance (400 million euros).
Among the main expenditure items on health insurance, the increased expenditure on health establishments is to be limited to 2.1 %. The hospital federations are warning of the consequences of this historically low figure, through a joint statement. According to them, “Never has the ONDAM been so low and disconnected from the rising trend of the needs, linked to the ageing of the population, the increase in chronic diseases and inflation.” “This PLFSS would represent the worst cure of economies for hospitals since the 2010s. It is tantamount to asking establishments to treat more with less means. The negative consequences will be definite: increased stress on personnel, deferred investments and worsening of access to healthcare.”
In addition to the economy measures on the expenditure on health insurance, the government has announced the freezing of social benefits (pensions, family benefits…) in 2026.
Nevertheless, the 2026 PLFSS does contain certain measures aimed at resolving medical deserts, such as the creation of a status of territorial outpatient medicine practitioner (announced in April 2025) or mandatory one-year placements in priority zones for general medicine students, as well as the establishment of a network of 5,000 France health establishments by 2027, without specifying with which personnel and which budget.
The bill also intends to pursue its 10-year strategy on palliative care announced in April 2024, “by securing access to palliative care units, by developing mobile territorial teams and by further deploying the availability of palliative care in the home.” In accordance with the aim of the strategy to increase the budget for palliative care by 1.1 billion euros over ten years, the 2026 PLFSS allocates an additional 100 million euros to increasing territorial coverage.
Despite these efforts, the proposed social security budget can but raise concerns on the continuity of the availability of healthcare by announcing such economies on health insurance expenditure, in particular for health establishments.
Inadequate measures for old age
Concerning old age, the proposed bill intends to “pursue the deployment of new services to reinforce the accompaniment of loss of autonomy.” The recruitment of 4,500 additional staff in EHPAD (retirement homes) is rather feeble in relation to the promises by Emmanuel Macron in 2022 to recruit 50,000 additional staff by 2027. Four years later, assuming that the positions created by the previous PLFSS were achieved, a mere 20,000 staff will have been recruited !
But especially, this figure is well below the needs of the sector whereas a recent survey by the National Federation of the Associations of Directors of Service Establishments for the Aged (FNADEPA) conducted with 1,600 directors of EHPADs, outpatient services and intermediate homes, indicates that 51 % of them are currently facing a shortage of personnel. Over 65 % of medico-social establishments or services (ESMS) consider that they will end 2025 in deficit.
On 16th October, 20 old-age federations and organisations organised a national mobilisation on the theme “The aged deserve better!” recalling the need for a multiple-year programming law for old age as intended in the “Bien vieillir (ageing well) law” dated 8th April 2024.
Moreover, the proposed bill includes a financial commitment of an additional 100 million euros to fund intermediate homes (autonomy residences or service residences for example).
Concerning the funding of dependency, the proposal includes “management measures” for the payment of the handicap compensation benefit (PCH) and the personalised autonomy benefit (APA), a benefit intended for those aged 60 or more who are losing autonomy. This is intended in particular to avoid adding such benefits to other services or indemnities. Adding this to the freezing of retirement pensions, the doubling of medical exemptions, fixed contributions and the unavoidable increase in the cost of mutual insurance associated with the transfer of expenditure, it is obvious that the aged and/or dependent are likely to be the first victims of all these budget cuts.
Family policies are being sacrificed in a context of falling birth rate
Finally, whereas our nation is facing a continuous fall in birth rate, the government, through this proposed bill, is rescinding on its birth-rate support.
The 2026 PLFSS includes an additional two months parental leave – presented as an important measure in support of families – in addition to maternity and paternity leave, in 2027. Although that measure constitutes a first step in response to the recommendations in the 2020 report “The first 1000 days” and to the needs of families, it remains well short of their needs.
During its audition at the National Assembly on 14th October, the National Union of Family Associations (Unaf) called for paid leave until the child’s first birthday. This new parental leave will be compensated at 70% of net salary the first month and 60% the second, as declared by the Health Minister Stéphanie Rist on Tuesday 21st October during her audition by the Social Affairs commission of the National Assembly. Currently evaluated at 300 million euros for the first year, the cost of this leave could increase according to the number of families concerned, as indicated by Aurore Bergé, the Minister for the Equality between men and women.
Other measures are concerning which will seriously affect the buying power of families:
- Freezing of child benefits which will no longer be index-linked to inflation;
- Delaying of the uplift of child benefits from 14 years to 18 years: child benefits, which are currently uplifted when the child reaches 14 years of age, due to increasing costs, will now only be gradually increased at 18 years of age.
As well as these 2026 PLFSS measures, the deletion of tax relief for school fees has been included in the proposed funding bill. This tax relief is currently at 61 € for secondary school pupils and 180 € for students.
Additionally, the choice of transferring resources from the family branch to other social security branches is questionable.
Whereas France is confronting a demographic cliff and that a renewal of generations is essential in order to ensure the continuity of our social model based on the solidarity between generations, the government appears to be choosing to sap its policy in support of families.
Alliance VITA recalls its support in favour of access to healthcare for all French people, as promoted by its campaign “We need healthcare, not euthanasia.” This social security funding bill further undermines access to healthcare, in particular for the most vulnerable. The government must confront the true challenges: by adopting an ambitious multiple-year programming law for the aged and by establishing a consistent policy in support of families.
Suivez-nous sur les réseaux sociaux :
