Global Health Insurance Updates: Policy Changes, Incentives, and System Reforms

Hopes fade in Congress for a health care deal before premiums soar in January

2 Dec 2025

Congress is grappling with roughly $35 billion in ACA subsidies set to expire, which cap premiums at 8.5% of income. Democrats want a straightforward extension, while Republicans, controlling both chambers, oppose a clean renewal and have yet to propose an alternative plan. Key sticking points include abortion restrictions under the Hyde Amendment, with GOP leaders seeking stricter limitations and Democrats rejecting changes. Without action, premiums could rise sharply starting January 1, creating political risks for Republicans ahead of the 2026 midterms. Lawmakers from both parties acknowledge the urgency but remain divided on timing, scope, and consensus for a solution.

South Korea debates health insurance rewards as other nations incentivize aging well

2 Dec 2025

South Korea’s insurance system largely ignores healthy older adults, treating those who stay active and avoid hospitals the same as heavier medical users, leaving many feeling unrewarded for reducing costs. Other countries have created incentives: Singapore’s Healthy365 app converts exercise into vouchers and transit credits; the Netherlands’ Vitality program cuts premiums for hitting activity targets; Germany offers cash rewards for checkups and fitness; Japan uses health points for local discounts; and the U.S. Silver Sneakers program provides free gym access, reducing falls and medical costs. These initiatives show that rewarding healthy aging lowers healthcare spending, supports independence, and benefits society. South Korea could similarly recognize “healthy agers” as contributors, linking activity and independence to tangible incentives. Encouraging older adults to stay mobile and engaged is a cost-effective investment in the country’s future.

My Number Switch: Former Health Insurance Cards Expire in Japan

1 Dec 2025

Japan is phasing out standard national health insurance cards, which expire on December 1, 2025, as the country transitions to using My Number cards that incorporate health insurance information. From December 2, 2025, patients should present either a My Number card with insurance details or a certificate of eligibility (shikaku kakuninsho) at medical institutions, though expired cards may be accepted until March 2026. Those without a My Number card or who choose not to register insurance information can use a certificate of eligibility issued by insurers. For cardholders who wish to link their insurance, registration can be completed at medical terminals, ATMs, or via the Mynaportal online platform. New applicants can apply for a My Number card by mail, online, or at designated photo booths, with guidance available from their municipality.