Unprecedented deficit and exponential health spending, but also extension of paternity leave and launch of a fifth branch dedicated to dependency: here are the main features of the draft budget of the Social Security 2021, which arrives Tuesday before the National Assembly.
An extraordinary deficit
For the current year, the Social Security deficit is estimated at 44.4 billion euros (against a little over 5 billion in 2019), with 30 billion for the health branch and 7.9 billion for the retirement branch .
Since the arrival of Covid-19 in France, the return to balance has been relegated to the status of an objective of “the life before” for two reasons: health expenditure has, logically, exploded (+ 10 billion euros) and the resources of Social Security, largely made up of social contributions, have been largely affected by the sharp rise in unemployment and the continued partial unemployment of many employees (- 27 billion).
And according to the Social Security financing bill (PLFSS), as it stands, the deficit for 2021, “still very strongly marked by the health crisis”, would still amount to 27.1 billion euros. To this must be added the impact of curfews since midnight Friday for 20 million inhabitants of large metropolitan areas.
An increasingly costly health crisis
Purchases of masks, reimbursements for tests, work stoppages, support for nursing staff and hospitals … The cost of the Covid-19 epidemic continues to climb and will exceed 10 billion euros this year. A sum to which is added a little more than one billion euros to finance the first commitments of the “Ségur de la Santé”.
That is to say an increase in the Ondam (National target for health insurance expenditure) of 7.6% for this year, against + 2.45% in the initial PLFSS, voted at the end of 2019.
And as neither the year nor the epidemic draws to a close, an upward revision of this expenditure is still likely.
Same thing for 2021: 4.3 billion euros have been budgeted for, in particular, masks, tests and the possible vaccination campaign, if there is a vaccine.
In addition for next year 7.9 billion euros to finance the “Ségur agreements”, signed in July.
In total, the government forecasts an Ondam increase of 3.5% in 2021.
Extended paternity leave
Emmanuel Macron recently announced: from next July, the duration of leave for a father – or the second parent – of an unborn or adopted child will be reduced from 14 to 28 days, of which 7 are compulsory.
The three days of birth leave will always be paid by the employer, and the remaining 25 days will be compensated by Social Security. As is already the case, seven additional days will be added in the case of a multiple birth.
The cost of the measure for the family branch is 260 million euros next year, then 520 million in 2022, in a full year.
Dependency gets its branch, for lack of funding
The PLFSS acknowledges the creation of a fifth branch of social security, dedicated to the management of loss of autonomy. It must be added to the four existing branches: sickness, retirement, family, accidents at work.
For 2021, it is only financed by solidarity credits for autonomy (CNSA), as well as those dedicated to the education allowance for disabled children, AEEH.
The Minister of Solidarity, Olivier Véran, had promised “at least one billion euros” more for this branch, far from the 9 billion that should be added by 2030 in view of the increase in the number of elderly people.
Emergency passages not requiring hospitalization will be the subject from next year of a “package” of a fixed amount, which will replace the current “co-payment” leaving the patient at 20%. the cost of their care.
Twelve new birth centers will be created in France, with an envelope of 2 million euros, bringing to twenty the number of these places that allow deliveries without hospitalization.
The provisional is long-term: the teleconsultations, multiplied by 100 in April, will still remain 100% covered by the Social Security for two years.
The supplementary disability allowance (ASI) will be increased from 2021 to 800 euros per month (compared to 750 euros currently).