Up to 446 out of 455 National Assembly (NA) deputies voted in favour of the revise to the Health Insurance Law during the eighth session of the 15th NA.

Notably, under the new law, in addition to groups of health insurance participants specified in the current law, others stipulated in other laws are added. Village health employees and midwives will also enjoy support to participate in health insurance as a way to encourage and motivate them.

Further amendments will be considered for a complete revision of the law in the future.

The amended draft introduces eight key changes, summarised as follows:

1. The law updates the categories of people required to participate in health insurance, clarifies payment responsibilities, methods and deadlines of the health insurance card, to harmonises the provisions with the Law on Social Insurance and other related regulations.

2. The law introduces new regulations for registering initial healthcare providers and for transferring patients between healthcare facilities, in accordance with the technical expertise level outlined in the 2023 Law on Medical Examination and Treatment.

3. A focus is placed on ensuring that health insurance coverage for medical care is

consistent, without regional distinctions. It maintains current coverage rates, while expanding benefits in certain areas, such as for rare or severe diseases, which will allow direct access to specialised healthcare centres. Additionally, the law now includes expanded coverage for children under 18 for conditions like strabismus and refractive errors. There is also provision for the management of chronic illnesses at grassroots healthcare levels, to strengthen primary healthcare.

4. The law revises the allocation of funds for health insurance medical care, preventive services and operational costs, specifying timelines for reporting the results of medical cost assessments to resolve delays in settlement and reimbursement.

5. New mechanisms are introduced for the reimbursement of medications and medical equipment transferred between healthcare facilities, as well as for clinical services provided at other centres in cases of shortages.

6. Specific provisions are added to address delayed or evaded health insurance contributions, alongside measures to enforce compliance.

7. The Ministry of Health is tasked with regularly reviewing and updating treatment protocols to ensure efficient medical care and smooth health insurance reimbursement. The law further outlines criteria for evaluating the appropriateness of healthcare services and emphasizes the use of digital technology, data sharing, and interconnected medical service results to improve healthcare delivery. It also aims to strengthen grassroots level healthcare capacity and introduces guidelines for the creation of a health insurance payment list for drugs, medical equipment, and services, ensuring transparency and accountability.

8. The amended law includes provisions for the issuance of electronic health insurance cards and mandates annual audits of health insurance expenditures by the State Audit Office, in alignment with the Law on Social Insurance.

At the session, in her report on the explanation, reception and revision of the draft Law amending and supplementing certain provisions of the Law on Health Insurance, Chairwoman of the NA’s Social Affairs Committee, Nguyen Thuy Anh, said that throughout the process of reception and revision, the NA Standing Committee had directed a thorough approach and implemented the policy of renewing legal thinking.

The policy ensured that the provisions were clear, substantive, concise, easily understandable and feasible, while being closely aligned with practical realities. Furthermore, there was an emphasis on enhancing decentralisation of powers, in line with the responsibilities and rights of agencies, organisations and individuals to improve implementation capacity. Administrative procedures were streamlined, and provisions were limited to those within the NA’s scope of authority.

The Government and ministries were tasked with stipulating details within their respective jurisdictions, ensuring that amendments could be made promptly when necessary. Regarding health insurance participants, contribution premiums payment levels and the responsibility to contribute to health insurance, many representatives expressed opinions on the regulations concerning eligible participants.

Therefore, the NA Standing Committee received feedback and revised the draft Law to maintain the same categories of participants as stipulated in the current law.

Additionally, the draft law proposed including groups already defined by other laws, and extending coverage to healthcare employees in remote villages, including village midwives, in order to encourage and provide fair policies for those who serve public health in rural and remote areas, ensuring equality with other groups in urban neighbourhoods.