Senior NHI premium exemption plan sparks equity concerns

Senior NHI premium exemption plan sparks equity concerns

2026-10-28

Now that Taiwan is a super-aged society, demand for elderly care continues to grow and welfare resources are increasingly scrutinized. The Legislative Yuan recently passed a bill exempting people aged 65 and older from National Health Insurance premiums starting next year, and this has prompted concerns about additional government spending and the potential financial burden on the younger generation, as well as whether other social welfare programs would suffer as a result.

The National Health Insurance system provides comprehensive healthcare to everyone in Taiwan and has earned international recognition for its range of coverage and services. Recently, the Legislative Yuan passed an amendment exempting people aged 65 and over whose income falls below the 20% tax rate from paying premiums, sparking widespread debate.

Hung Tzu-jen
Taiwan College of Healthcare Executives director
People aged 65 and over account for about 43% of healthcare spending, with average annual medical expenses exceeding NT$90,000 per person. These costs will continue to rise with inflation, squeezing funding for other areas, such as the Long-Term Care 3.0 project, salary adjustments for healthcare workers, and the pace at which new drugs and technologies are covered by NHI.

Liu Huan-jui
Taiwan Young Patient Association secretary-general
The Executive Yuan estimates that expanding NHI premium subsidies to people aged 65 and older would require nearly NT$40 billion in additional funding each year. While supporting older people in financial need is important, Taiwan must establish a fair and sustainable system to ensure the NHI has sufficient resources to improve care, introduce new drugs, and safeguard the health of all generations.

Experts estimate that 83% of people 65 and over will qualify for the premium exemption. While this could ease the financial burden for older people, the additional costs could be shifted to younger generations and affect other social programs.

Wu Yu-chin
Active Aging Taiwan chair
Taiwan’s NHI system, a source of great pride, is something everyone cherishes and hopes will be sustainable. But this amendment makes young people wonder if they will have to shoulder the cost of NHI in the future, which would be unfair to them.

As the government adjusts its policies to support the nation’s aging population, it’s a challenge to ensure resources are allocated fairly and effectively.

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