Conor Sheehan
Question:1112. Deputy Conor Sheehan asked the Minister for Health the steps her Department is taking to combat the rise in health insurance premium costs; and if she will make a statement on the matter. [6353/26]
View answerTuesday, 27 January 2026
Questions (1112)
Written answers
As Minister for Health, I am responsible for the legal framework governing the private health insurance market, which operates on the principles of community rating, open enrolment, lifetime cover and minimum benefit. These protections are designed to support fairness and keep health insurance as affordable as possible for all consumers.
Community rating ensures that everyone can purchase the same policy at the same price, regardless of age, gender or health status. This is supported through the Risk Equalisation Scheme, under which funds are redistributed in the form of risk equalisation credits to support insurers with older or higher-risk members. These credits are funded by a stamp duty levy paid by insurers on each policy issued. The credits and levies are adjusted annually to maintain the sustainability of community rating and the long-term stability of the market.
Each year, the Health Insurance Authority (HIA) analyses market data and makes recommendations to me on the appropriate levels of credits and stamp duty required to maintain balance in the Risk Equalisation Scheme. These recommendations ensure that the scheme remains self-financing and that community rating continues to function effectively.
The private health insurance market operates on a competitive, commercial basis. Insurers set their premiums in line with their own commercial decisions and strategies, within the framework of the Health Insurance Act, as amended.
Premium increases are driven by factors including medical inflation (which includes the introduction of new high-tech treatments), staffing costs within the private healthcare sector, and professional and hospital fees. These fees are negotiated between insurers and providers. Other factors include claims experience, benefit changes, and operating costs. As Minister for Health, I have no role in the commercial decision-making of private health insurers, including decisions on premium prices.
The Health Insurance Authority maintains regulatory oversight of insurers and ensures compliance with community rating, open enrolment, and lifetime cover requirements, which helps to keep the health insurance market fair, accessible and sustainable for all consumers. The Authority’s functions include monitoring the health insurance market and developments in health insurance generally, and advising me in relation to these matters. In addition, the HIA maintains a free online comparison tool to help consumers identify better-value plans and make more informed choices based on the level of coverage required, which can help mitigate the impact of premium increases at individual level.