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Social security financing for 2018

The 2018 social security financing bill was presented to the Council of Ministers on 11 October 2017 by Agnès Buzyn, Minister for Solidarity and Health, and Gérald Darmanin, Minister of Public Action and Accounts. With the aim of bringing the social security accounts back into balance by 2020, this bill puts into action the undertakings made before the French people.


The efforts to rein in spending driven by the 2018 social security financing bill are helping to reduce the public deficit as pledged by the Prime Minister in his General Policy Statement. In 2018, the deficit in terms of the general scheme and the Old-Age Solidarity Fund is on track to reach €2.2bn – which is €3bn less than the 2017 forecast. The social debt, managed by the Caisse d’amortissement de la dette sociale (a sinking fund established to redeem French social debt/Cades), is set to be eliminated in 2024.

Regarding expenditure and investments, the National Health Insurance Spending Target (ONDAM) forecasts 2.3% spending growth for 2018. For a total amount of around €200bn, this trajectory represents €4.4bn worth of new expenses compared with last year. 

Among the key reforms, the social security financing bill will enable the self-employed workers' health insurance scheme (RSI) to be affiliated to the general scheme from 1 January 2018. Given their specific situations, they will retain their own rules and contribution rates.
The 2018 bill outlines major steps forward for launching priority areas for action in terms of innovating the health service, rolling out telemedicine and speeding up the registration of new procedures for reimbursement – the whole underpinned by digital development. These areas for reform will be funded through a sweeping investment plan.

Key points at a glance

For greater spending power and support for economic activity:

  • Reduction in social contributions, so freeing up €7bn worth of spending power for the labour force;
  • Exemption from paying social contributions, from 2019, for business founders in the year they start up their venture;
  • Conversion of the competitiveness and employment tax credit (CICE) into lower contributions for employers, from 2019.

For greater prevention at the heart of the health strategy:

  • Increase in the price of a pack of cigarettes, poised to reach €10 in three years' time;
  • Extension of mandatory vaccinations to infants under 18 months of age. 

For greater protection of our most vulnerable fellow citizens:

  • €22bn in funding for institutions and facilities caring for individuals with diminished independence and those with disabilities;
  • increase in the monthly minimum old-age pension amount, by €100, over three years;
  • increase in the supplementary family benefit paid to the poorest families;
  • increase in the family support allowance for single-parent families;
  • 30% increase in the maximum amount single-parent families can receive to help pay for childcare.

The Government's priority is to continue improving the range of health care available while keeping health expenditure in check. Reducing the social security deficit and social debt is also at the top of the Government's agenda.
With the 2018 social security financing bill, the aim is to bring the social security accounts back into balance by 2020 and eliminate social debt by 2024. Efforts to rein in health spending are having to be made at a time when this is on an upward trajectory, however, with a spending target up by 2.3% compared with 2017.

21 November 2017: adoption of the bill at first reading at the Senate
31 October 2017: adoption of the bill at first reading at the National Assembly
11 October 2017: presentation in the Council of Ministers