The CNSS Initiates a Financial and Statistical Study to Enhance the Sustainability of Mandatory Health Insurance Schemes
The National Social Security Fund (CNSS) has launched a call for tenders for an in-depth actuarial study on the Mandatory Health Insurance (AMO) schemes. This initiative comes amid a broader effort to expand medical coverage in Morocco and growing concerns about the financial sustainability of the system.
A Comprehensive Assessment of AMO Schemes
With an estimated budget of 4 million dirhams, this study aims to analyze the financial viability of the various regimes managed by the CNSS and anticipate necessary adjustments to ensure their sustainability.
The study will specifically cover the schemes for salaried workers, self-employed workers, as well as the AMO Tadamon and AMO Achamil programs. Projections will also include students currently under the CNOPS, who are expected to be gradually integrated into the CNSS system.
Ten-Year Projections and Two Scenarios
The primary objective is to assess the financial equilibrium of the schemes over a horizon of at least ten years, determining their balance rate and measuring the impact of various potential reforms.
The study will be based on two scenarios: one maintaining the status quo and another incorporating structural reforms, such as revising the national reference pricing, adjusting reimbursement rates, modifying contribution bases, and changing eligibility criteria.
Recommendations to Strengthen System Sustainability
Beyond the diagnosis, the mission will propose concrete recommendations to ensure the durability of the AMO schemes. Among the suggested avenues are adjusting contributions, redefining contribution bases, improving the functioning of the schemes, and enhancing mechanisms for controlling health expenditure.
The study will be structured in four phases, ranging from initial analysis to scenario formulation and final recommendations.
A Context of Vigilance on System Sustainability
This launch occurs as the Court of Auditors has recently warned about the structural weaknesses of the AMO schemes. The institution specifically pointed out the rapid rise in health expenditures compared to resources, difficulties in collecting contributions from self-employed workers, and delays in integrating certain beneficiary categories.
It also highlighted risks associated with cost control, system oversight, and fraud, in a context of rapid expansion of medical coverage.
In this framework, this actuarial study represents a key step in securing the financial balance of the system and supporting future reforms of mandatory health insurance in Morocco.
