Bulgaria’s National Assembly amended the Health Insurance Act to add a second NHIF deputy governor for better management amid growing fund deficits. Controversy arose over reinstating spending limits on medical care, with critics warning of financial strain on hospitals and care access risks.
The Bulgarian National Assembly approved amendments to the Health Insurance Act, introducing a second deputy governor to the National Health Insurance Fund (NHIF) in a bid to improve management efficiency and stability. The bill, supported by 116 votes with 52 against and 25 abstentions, was sponsored by Dragomir Stoynev and MPs from BSP – United Left. Socialist MP Ivan Ibrishimov explained that dividing responsibilities between two deputy governors would create a more sustainable and flexible management structure with enhanced control. The NHIF Governor will define the powers and portfolios of the deputy governors, with the second to be elected within three months, serving alongside the incumbent.
The legislation also sparked controversy regarding a proposal, introduced by GERB-UDF MP Valeri Lachovski, to tie NHIF payments for medical care strictly to contractually agreed limits and the earmarked budget, including reserves approved by the NHIF Supervisory Board. Opposition MPs from Vazrazhdane, Continue the Change – Democratic Bulgaria (CC-DB), and Alliance for Rights and Freedoms voiced concerns that this reinstated spending caps previously abolished by a 2024 Constitutional Court decision. Critics argued this could lead to hospitals refusing patients due to financial shortfalls and question who would cover care costs exceeding contract limits.
CC-DB MPs highlighted the NHIF’s growing deficit, projected to reach BGN 270 million this year and BGN 416 million including the previous year’s shortfall, surpassing NHIF reserves of BGN 276 million. They warned the current approach merely delays addressing financial imbalances, effectively transferring the burden to the next fiscal year. Hasan Ademov of the Alliance for Rights and Freedoms argued that appointing a second deputy governor will not solve the deficit; instead, rationalizing spending through pricing methodologies for clinical pathways and medical staff was essential.
In response, GERB-UDF’s Kostadin Angelov reassured that no Bulgarian citizen in need of medical treatment would be denied access to healthcare. The debate underscores ongoing challenges in balancing NHIF financial sustainability with ensuring universal access to medical services.
