The Health Fund projects a €210M deficit for 2025, with €21M in planned savings. Covering the remaining €188.9M requires additional state funding or reserve use, which needs a legislative amendment. The final budget proposal will be submitted to the Riigikogu by the government.
Estonia’s healthcare financing is under significant strain, with rising costs, an aging population, and fluctuating tax revenues placing pressure on the system. According to Minister of Health Riina Sikkut, the growing demand for healthcare services and the increasing prevalence of chronic diseases are driving up expenditures. Meanwhile, changes in the labor market and a declining workforce have led to irregular social tax revenues, impacting healthcare funding.
The Health Insurance Fund (HIF) is facing a €210 million deficit in 2025, €60 million more than previous estimates due to lower-than-expected tax revenues. The Health Fund’s reserve stands at €700 million, with €500 million in retained earnings.
While €21 million in efficiency savings has been identified, covering the remaining €188.9 million will require either state funding or using reserves, which would consume nearly a quarter of available reserves in one year. Legislative changes would be needed to authorize reserve use at this level.
“The underfunding of healthcare is not a new issue—it has been discussed for years,…While using reserves is necessary in the current budget crisis, if we continue this approach, our reserves would be depleted by 2027.” said Rain Laane, Chairman of the Health Fund.
Minister Sikkut emphasized that using reserves is only a temporary solution. She stressed the need for a long-term financing model, proposing that the state budget cover medical expenses for people under 19 years old to ease the burden on the Health Insurance Fund.
“In the future, we must agree on a sustainable healthcare financing model. One option, which I presented to the government in the spring, is allocating state budget funding for children’s healthcare costs,” Sikkut explained.
To improve financial sustainability, the Health Fund is focusing on digitalization, automation, prevention programs, and strategic service planning, which are expected to generate €21 million in savings in 2025. The Health Fund’s total budget for 2025 exceeds €2.5 billion, with the majority allocated to healthcare services, medicines, and temporary disability benefits. The final budget will be approved by the Health Fund’s Council after the Riigikogu adopts the state budget.
With healthcare costs rising and funding shortfalls deepening, Estonia must take decisive action to ensure long-term healthcare sustainability. While reserve use provides temporary relief, structural reforms and additional resources are essential to prevent future crises.
