The Senate voted to phase out the CASS health insurance certificate by 2027

The Senate has adopted a legislative proposal whereby healthcare institutions and service providers will no longer be able to require patients to present a paper CASS insurance certificate, in situations where insured status can be confirmed directly through the electronic system of the National Health Insurance House. The measure is set to apply until 31 December 2027.

What remains unchanged

The bill does not modify the rules governing insured status, nor the obligations related to the payment of health insurance contributions (CASS). No new categories of insured persons are introduced, and the basic healthcare services package remains unchanged. The only significant change concerns the way in which insured status is proved: if the information can be verified electronically, patients can no longer be asked to provide a physical certificate.

Electronic verification as the primary confirmation method

According to the bill, electronic verification will become the primary method of confirming insured status, and its result will carry the same legal weight as a paper certificate. Should a document still be required, the healthcare service provider will be able to generate, download, and retain an electronic version, secured by a qualified electronic seal and timestamp, which may be used as evidence.

When a physical certificate is still required

A paper document may only be requested in exceptional circumstances, where electronic verification is not possible — for instance in the event of technical issues, temporary unavailability of IT systems, or the inability to identify the individual. Otherwise, if insured status can be confirmed electronically, the provider will not be permitted to request a physical certificate.

The bill further provides that the absence of the national health card or certificate cannot be grounds for requiring the patient to pay for healthcare services, provided that insured status is confirmed through the electronic system. The insured person will only need to supply the data required for verification, without being automatically obliged to present paper documents.

Exception for those who decline the health card

For individuals who refuse, on religious or conscientious grounds, to receive the national health insurance card, the bill retains the possibility of issuing and using the insurance certificate as proof of their status. Paper documents may also be requested in other exceptional situations, where electronic verification is not possible for technical reasons or due to temporarily unavailable IT systems.

Transition period until the end of 2027

Until 31 December 2027, both the national health insurance card and the electronic identity card may be used interchangeably for authentication on the Health Insurance IT Platform and for proving insured status. This period is intended to allow IT systems time to adapt and to permit a gradual transition to electronic verification.

Bill adopted with 111 votes in favour

The Senate plenary adopted the legislative proposal with 111 votes in favour and two votes against. The bill is to be debated by the Chamber of Deputies, which has decision-making authority. If adopted and promulgated in its current form, the legislation would reduce the need to present physical documents and streamline procedures for patients required to prove their insured status.