(Jan. 11, 2011) On January 4, 2011, Taiwan's legislature adopted controversial amendments to the National Health Insurance Act, after opposition Democratic People's Party (DPP) legislators walked out in protest following the rejection by the “pan-blue”-dominated body of the DPP proposal to base health insurance fees on household income. (Flora Wang & Vincent Y. Chao, KMT Caucus Passes Amendment to NHI, TAIPEI TIMES (Jan. 5, 2010), at 1, http://www.taipeitimes.com/News/front/archives/2011/01/05/2003492710.) The pan-blue alliance comprises the ruling Kuomintang (KMT, or Nationalist Party), the People First Party, and the New Party.
According to an editorial in the Taiwan newspaper China Times, the main aims of the amendments are “to make premiums fairer, to cover the shortfall in the health care system budget, and to make the system more egalitarian. The amended law gets a passing grade.” (Editorial, Health Insurance Must Not Become the Meat Chopper for Health Ministers, CHINA TIMES (Jan. 6, 2011), http://www.kmt.org.tw/english/page.aspx?type=article&mnum=113&an
um=9100&kw=pan+blue.) Highlights of the amendments are:
- The national health insurance scheme is changed from a single-track to a dual-track system, with a supplementary premium in addition to the current standard premium that is calculated monthly on the basis of income alone. (Id.) The new premiums set by the Act are 4.91% of an individual's monthly salary (vs. the current 5.17%) for the standard premium and 2% of any additional income over NT$2,000 (about US$68) “including interest, professional practice income, rent, stock dividends and bonuses exceeding four months' salary” for the supplementary premium. (Grace Kuo, Legislature Passes 2G Health Insurance Plan, TAIWAN TODAY (Jan. 5, 2011), http://taiwantoday.tw/ct.asp?xItem=141829&ctNode
- Expatriates living abroad for long periods must return to Taiwan for a minimum six-month period of maintaining legal household registration in the country or must have paid premiums in the last two years, in order to receive national health insurance benefits. (Kuo, supra.) In the past, citizens living abroad could make a special trip back to Taiwan each year “to renew their policies, pay the premium for one month, and immediately begin enjoying exactly the same benefits as everyone else.” (CHINA TIMES, supra.) However, the six-month waiting period requirement will not apply to those registered in the system who have already left the country before the revised Act's implementation and who return to Taiwan for the first time within one year after amended law's implementation.
- Eligibility requirements for foreign residents are also tightened. The revised Act stipulates that only those residency document holders with employment in Taiwan or who have stayed in the country for at least six months can receive coverage. Formerly, foreign residents eligible for coverage under the act included those “who had lived in Taiwan for a period of more than four months and full-time foreign workers employed by schools.” (Wang & Chao, supra.)
According to Minister of Health Yaung Chih-liang, “[a]round 83 percent of the population will pay less for health insurance, while 16 to 17 percent of the people will pay more.” (Kuo, supra.) The new system is expected to generate NT$508.6 billion (about US$17.4 billion) in health insurance premiums per year, which Tai Kuei-ying, Director-General of Taiwan's Bureau of National Health Insurance, stated will balance the current system's financial shortfall (now over NT$60 billion) (about US$2 billion) in five years. (Id.) The government's initial estimates indicate that the supplementary premium would bring in additional yearly health insurance revenues of NT$20 billion (about US$713.9 million). (Wang & Chao, supra.)
The Executive Yuan (Cabinet) will determine the date of implementation of the revised Act. The Department of Health has expressed the hope, however, that the new system will be implemented in April 2012. (Kuo, supra; Complete Text of the Amended National Health Insurance Law [in Chinese] [adopted by the Legislative Yuan on Jan. 4, 2011, not yet promulgated by the President], Taiwan Medical Association website, 全民健康保險法全文
; mso-ascii-font-family: 'Times New Roman' mso-hansi-font-family: 'Times New Roman'” lang=EN-US>全民健康保險法全文.doc (last visited Jan. 10, 2011).)