The proposal comes as the existing support policy under Decree 75/2023 is set to expire on October 31, 2026, while amendments to the relevant regulations have yet to be finalized.

Without transitional measures, approximately 1.3 million people could lose government assistance with their health insurance premiums.

Nearly 2 million people maintain health insurance through subsidy program

Under Decree 75/2023, the state budget covers at least 70% of health insurance premiums for ethnic minority residents living in communes classified as Area II or Area III, or particularly disadvantaged villages in ethnic minority and mountainous regions during 2016-2020, but which were no longer classified as such during 2021-2025.

The policy was introduced for a 36-month period, running from November 1, 2023, through October 31, 2026.

Over nearly three years, it has helped an average of approximately 2 million people annually maintain health insurance coverage, reducing the number who drop out after losing eligibility for fully subsidized insurance cards.

According to Ministry of Finance figures cited by the Ministry of Health, 628,945 people benefited from the program during the final two months of 2023, with government subsidies exceeding $2.7 million.

By 2025, participation had increased to more than 2.04 million people, with financial support exceeding $69 million.

That year, total health insurance premiums payable by the group exceeded $82 million.

The central government covered 70% of premiums, while local authorities provided an additional approximately $12.6 million. Participants contributed more than $12 million themselves, accounting for 14.6% of the total.

Many localities have yet to cover remaining premiums

The Ministry of Health estimates that, as of October 2026, more than 1.4 million people were still receiving government support for health insurance premiums under Decree 75/2023.

The 70% government contribution amounted to more than $41 million, while the remaining 30% totaled over $17.6 million. Local budgets had provided an additional $8.4 million toward that balance.

Currently, 15 provinces and cities cover the entire remaining 30% of premiums, while two provinces provide additional support ranging from 5% to less than 30%.

Another 17 provinces and cities offer no supplementary assistance.

Most beneficiaries live in the northern mountainous provinces, the north-central region and the Central Highlands.

In many localities, residents must still pay the remaining portion of their health insurance premiums themselves.

Health insurance costs could more than triple for some residents

The Ministry of Health warned that if the subsidy policy is not extended beyond October 31, approximately 1.3 million ethnic minority residents could lose government assistance with their health insurance premiums.

In the 17 provinces and cities that do not provide additional support, residents could be required to pay the full premium, approximately 3.3 times their current contribution.

"Most people in this group belong to low-income households and have limited ability to pay premiums themselves, creating a significant risk that they will discontinue their health insurance coverage," the ministry said.

Losing coverage could disrupt access to medical examinations and treatment, particularly for people with chronic illnesses requiring long-term care.

The ministry also warned that reinstating subsidies after a lapse could create administrative complications, including additional premium collections, refunds, payment adjustments and the reissuance of health insurance cards.

A decline in participation in areas with large numbers of eligible residents could also affect Vietnam's health insurance coverage targets for 2026-2030.

To prevent interruptions in healthcare benefits, the Ministry of Health has proposed that the government continue covering at least 70% of premiums for eligible ethnic minority residents from November 1, 2026.

The transitional support would remain in place until a decree amending and supplementing provisions of Decree 188/2025 takes effect.

According to Ministry of Finance estimates cited in the proposal, maintaining the 70% subsidy for approximately 1.3 million people during the final two months of 2026 would require around $7.9 million in state funding.

For 2027-2030, the average annual cost is projected at approximately $47.5 million.

Vo Thu