The signature of the new Muface concert The 2025 and 2026 financial years, which will determine how much money the Ministry of Digital Transformation and Public Service will pay for the health care of civil servants, is just around the corner. The mutual society has already made its move: according to several media reports, the financing of this model will increase by 24% for 2025 and 1% for 2026, which represents an average annual increase of 12.5%. According to private healthcare, this figure is entirely “insufficient” to maintain the sustainability of the mutual fund system.
Muface’s decision to apply this increase responds, in part, to the losses that have been accumulating for years the three entities that provide the service: SegurCaixa Adeslas, Asisa and DKV. These companies have been demanding an increase in premiums, due to the financial imbalances they have experienced as a result of their participation in the health insurance model for civil servants.
While waiting to hear the official offer from the Administration for the new Muface agreement, the Institute for the Development and Integration of Health (IDIS Foundation) —an entity formed by the main companies and institutions in the health and social health sector in Spain— warns of the “risk that this proposal poses to maintaining the model due to its insufficiency”. For this reason, the organization calls for “reconsidering” the conditions considering the losses that the entities that provide the service have been accumulating for years.
He believes that “the average increase in the premium must guarantee that insurers can, in a balanced way, cover the economic and health care costs required to cover this group.” In this regard, he points out that “while public investment per capita per person has grown by 53% in the last ten years, the amount allocated to mutual insurance companies has grown by only 32%.”
This produces, in the specific case of Muface, Losses of more than 142 million euros per year in 2023». A situation that is due, according to IDIS, to the «high accident rate of the group, close to 110%». Therefore, the proposal for the present agreement «continues to be insufficient for the viability of the model».
Administrative mutualism is a coverage mechanism of the special Social Security regime for state officials (through Muface, Mugeju and Isfas) that improves the accessibility of the health system and helps control health expenditure. In the case of Muface, the average premium is 984 euros compared to 1,736 for the general regime (which makes it 76% lower) for the 1,068,771 members under this regime.
“With this proposed increase, the per capita investment continues to be significantly lower than that of the general regime, not approaching it, as has occurred in this model in past times,” claims IDIS. In this regard, the entity also highlights that the increase proposed for the second year of the agreement (1%) is “especially burdensome”.
They also point out that “70% of Muface employees voluntarily choose their medical care in private healthcare, highlighting the quality and accessibility of the sector, which results in a relief of healthcare resources in the National Health System.” Therefore, in the event that the insurance companies that provide services to mutualists choose to abandon the model, would generate “a very complex situation for the health system itself”.
Adding the assistance of this group would have “a direct impact on public activity,” warns IDIS. According to its knowledge of the sector, this would affect the care model because “visits to Primary Care and A&E would directly increase, and waiting lists for outpatient consultations and surgeries would also increase, causing a aggravation of the access problems that already exist today».
In conclusion, the IDIS Foundation urges that the increase in the budgetary allocation of the Muface agreement allow for achieving financial and health conditions “on a fair basis” that “provide the opportunity to continue maintaining a sustainable model for the National Health System as a whole.” You may be interested in:New notice to Muface retirees and mutualists: this is what they will have to pay for medicines