Catherine Ardagh (Fianna Fail) | Oireachtas source

I welcome the Minister of State to the House. I am taking this matter on behalf of my colleague, Senator Swanick, who is a doctor.

The Bill is designed to support risk equalisation, which will mean our health insurance market will allow older citizens and people with illnesses to afford health insurance. Community rating ensures these people are not discriminated against in favour of younger, healthier people. My party, Fianna Fáil, has always supported risk equalisation and community rating.

The main purpose of the Bill is to revise the number of risk equalisation credits to be paid in respect of age, gender and level of cover from 1 April 2019 as required annually. It will amend the Stamp Duties Consolidation Act 1999 to revise the community rating stamp duty levies required to fund these equalisation credits.

The Bill will make changes to the governance of the VHI. The board of the Health Insurance Authority will be increased from five to seven members and the quorum from three to four. It will amend section 4 of the Voluntary Health Insurance (Amendment) Act 1996 to provide for a change in the make-up of the VHI board, which removes the restriction on the number of healthcare providers on the VHI board and requires the Minister to give consideration to the mix of skills present on the VHI board when making appointments. It will also amend section 1 of the Voluntary Health Insurance (Amendment) Act 1998 to permit VHI to sell international plans directly without ministerial approval.

During the last Dáil, experts recommended the introduction of lifetime community rating, which seeks to address the inequity of people waiting until they are older to take out health insurance and paying the same as those who have been health insurance consumers for decades. From 2010 to the end of 2014, the number of people under the age of 60 with health insurance declined, while the number of those over the age of 60 increased. In the six-month period after the introduction of lifetime community rating in 2015, there was an increase of almost 56,000 in the number of people with health insurance. From mid-2017 to mid-2018, the market increased by approximately 48,000 and now stands just below what it was in December 2010.

My party's values support our older people and our sick. We genuinely value older people and the dignity of each person in his or her illness, medical condition or disability, which is why in government we decided on a comprehensive plan to support older and sick people who have private health insurance.We are firm in our view that the principle of solidarity should apply in private health insurance as well as in public health services. More than 2 million people in Ireland have private health insurance cover, nearly 445,000 people are aged 60 years and lower. Many have paid for health insurance their entire adult lives. They have a fair expectation that the health insurance market will not be permitted to diminish their coverage. It is right for people to expect not to face higher health insurance prices because of their age or because of a particular medical condition. This country's policy has long been that the health insurance market should be community rated and people know this and rely on it.