State Budget to Add 18 Billion Crowns for Health Insurance of Non-Working Citizens

The Czech government is preparing a draft state budget for 2027 with total spending exceeding CZK 2.5 trillion, and healthcare remains one of the largest spending categories. According to calculations, for every thousand crowns in the budget, about 75 crowns go to healthcare — yet the Ministry of Health itself receives only around five crowns of that amount, or CZK 12.7 billion for the entire year.

The bulk of state healthcare funding doesn't flow through the ministry but through the General Treasury Administration, which handles payments for so-called state-insured persons (children, pensioners, the unemployed and other groups whose contributions are covered by the state). Under the draft budget, this payment will total CZK 175.7 billion in 2027 — CZK 18 billion more than the previous year.

Where the discrepancy in figures comes from

Earlier, the government had considered a bill to raise payments for state-insured persons by as much as CZK 21 billion, and in June there was even talk of increasing payments for pensioners by CZK 24 billion, three billion of which would come from the insurance companies' own savings. However, the current draft budget sets aside a smaller amount — CZK 18 billion.

According to Ministry of Health spokesman Martin Novotný, the discrepancy is explained by updated forecasts: the number of state-insured persons has grown due to caregivers (adding about CZK 3 billion in revenue to the system), and the Finance Ministry's August forecast showed an additional CZK 3.7 billion in revenue from working citizens' insurance contributions compared with the April estimate.

Without changes to the law, the calculation base for the contribution per state-insured person in 2027 would have been CZK 16,579, with a monthly payment of about CZK 2,238. The amendment currently under consideration raises these figures to CZK 18,362 and CZK 2,479 respectively. The ministry stresses, however, that the final amount has not yet been approved — neither the budget nor the amendment to the law has been passed in its final form.

The whole system runs on CZK 604 billion

It's important to distinguish between money from the state budget and the total volume of the compulsory health insurance system. In 2027, the system is expected to manage roughly CZK 604 billion — but this is not the amount paid directly by the state; rather, it represents the combined revenue from contributions by employees, employers, entrepreneurs, and state payments for the insured.

Health Minister Adam Vojtěch (for ANO) says the emergency increase in the state payment is meant primarily to stabilize the system, while measures are being prepared in parallel so that insurance companies no longer have to regularly dip into their reserves.

Insurers are spending down reserves

According to the Union of Health Insurance Companies, this year's deficit could reach CZK 22.8 billion — a shortfall insurers are covering from their own reserves. "Emergency measures have helped us get through this year, but on their own they won't ensure a long-term balance between revenue and expenses," said union president Martin Balada.

He noted that healthcare spending will keep rising due to an aging population, the emergence of new, expensive treatment methods, and rising staff costs. Petr Musil, a member of the National Budget Council, believes there is room to improve efficiency — for example, by streamlining the hospital network and promoting prevention and a healthy lifestyle.

Minister Vojtěch acknowledges inefficiencies within the system and expects savings of around CZK 6 billion next year from a new tariff decree, stressing that this should not affect the quality of patient care. Prime Minister Andrej Babiš, for his part, sees the main potential for savings in drug procurement — in his estimation, billions of crowns could be saved if hospitals held joint procurement tenders more often.

The final parameters of the entire state budget should become clear once the government approves it on Monday. According to the Finance Ministry's published draft, total budget spending for next year is expected to reach CZK 2.578 trillion, with revenue at CZK 2.189 trillion — leaving a deficit of CZK 389 billion. However, representatives of the ruling coalition say the deficit could still be reduced by several billion.

Read also: Giving Birth in Czechia as a Foreigner: Insurance and Maternity Hospitals 2026

Source: novinky.cz