Dutch Council of State warns health deductible cut risks harming vulnerable groups
The Dutch government’s plan to lower the mandatory health insurance deductible from 385 to 165 euros has drawn sharp criticism from the Council of State, which warned Monday that the proposal is too broad, could financially harm vulnerable groups, and may undermine the long-term sustainability of the healthcare system.
In its official opinion dated June 11 and published June 16, the advisory division of the Council of State urged lawmakers not to submit the bill to the Tweede Kamer unless major adjustments are made. The plan aims to amend the Health Insurance Act (Zorgverzekeringswet), a move the government says will reduce the number of people delaying or skipping necessary medical care due to financial reasons.
However, the advisory body said the measure lacks apparent targeting. While the government’s own explanation states that the burden of the deductible falls heaviest on vulnerable populations—such as those with lower incomes, limited health literacy, or chronic illnesses—the proposed cut does not directly address those groups, making it a "non-targeted measure."
The Council also warned that lowering the deductible by 220 euros would likely drive up nominal health insurance premiums by around 200 euros per year per person. That increase, the advisory said, will erode much of the intended benefit and could even make matters worse for some. “Certain vulnerable groups may end up worse off financially,” the Council noted.
Specifically, people with low incomes who do not fully pay the annual deductible may face higher insurance costs without seeing proportional savings. The Council also highlighted the government’s simultaneous plan to eliminate the allowance for disabled individuals. According to the advisory division, the financial loss from canceling that allowance would exceed the savings these individuals might gain from the lower deductible.
The opinion further argues that the change offers no lasting solution to problems with healthcare affordability. The deductible is scheduled to be indexed again starting in 2030, which reportedly means it will likely begin to rise in future years. “It raises the question of how the legislator intends to deal with the deductible structurally and what the consequences will be for financial access to care, especially for vulnerable groups,” the Council wrote.
Lowering the deductible may also lead to an increase in demand for healthcare services by lowering the financial barrier to access, the advisory stated. This could worsen existing problems in affordability and staffing capacity across the healthcare sector.
Given that the financial burden of the deductible primarily affects vulnerable populations, the Council concluded that targeted interventions would be more appropriate and less harmful than the current proposal. “The advice is therefore not to submit the bill to the Tweede Kamer unless it is amended,” the Council of State said.
The government’s proposal is linked to a separate bill that would abolish compensation for disabled individuals, which also received a formal opinion from the advisory division of the Council of State on June 11.
