EFAS: what uniform financing changes for your premium
From 1 January 2028, cantons and insurers will pay for care under a single key. Here is what actually changes — and what nobody can yet put a figure on.
The timetable, as it stands
- 24.11.2024The people accept the reform with 53.31 % of the vote.
- 2026Consultation on the implementing ordinances.
- 01.01.2028All outpatient and inpatient services move to the single key.
- 2030Second consultation, for nursing care services.
- 01.01.2032Nursing care services join the single key in turn.
The perverse incentive the reform fixes
Today two identical treatments are not paid from the same pockets. An operation performed in hospital is at least 55 % financed by your canton; the same operation performed as an outpatient is 100 % financed by premiums. The asymmetry pushes towards hospitalising what could be treated in half a day. From 2028 the key is the same everywhere.
| Type of service | Cantons’ share | Premiums’ share |
|---|---|---|
| Inpatient services | at least 55 % | at most 45 % |
| Outpatient services | 0 % | 100 % |
| Nursing care services | variable | variable |
| All services | 26.9 % | 73.1 % |
Will your premium fall? Nobody has quantified it
« premium payers see their burden decrease relative to the current system, because the tax-financed share no longer shrinks »
Read the FOPH's sentence to the end: the burden decreases "relative to the current system". That is a comparison with a trajectory, not a promise of a lighter bill. Concretely: the shift from hospital to outpatient care will continue, and without EFAS it would load a growing share of the total onto premiums. The Confederation publishes no reduction percentage, and we will not invent one.
What does not change for you
- Your deductible and co-payment stay the same: the reform changes who pays, not what you pay at the counter.
- The catalogue of reimbursed services does not move.
- You still choose your insurer freely, and it is still obliged to accept you.
- The 30 November termination deadline is unchanged.
A reform that was voted, not a proposal
On 24 November 2024 the people accepted the amendment to the Health Insurance Act with 53.31 % of the vote. What remains to be written are the implementing ordinances — put to consultation in 2026 and 2030. The 2028 date is not a hypothesis.
Sources
- OFSP — Modification de la LAMal : financement uniforme des prestations
- OFSP — Votation populaire du 24 novembre 2024
FOPH, "Amendment of the Health Insurance Act: uniform financing of services" and the page on the popular vote of 24 November 2024. Checked on 25 August 2026. Quoted passages are the FOPH's. Primes 2026.